Wollheim F A, Carlsson J, Forsgren A, Pettersson H
Clin Rheumatol. 1984 Mar;3(1):75-9. doi: 10.1007/BF02715700.
We report the case of a 76-year old woman who presented with a palindromic onset of seropositive rheumatoid arthritis. After suffering from a fulminant pulmonary infection she developed serologic tests for ornitosis, mycoplasma, pneumocystis carinii and low titer yersinia. Also the rheumatoid factor titer increased and the antinuclear antibody test became positive. Clinically, the course of a rather benign polyarthritis changed into a rapidly progressive deforming disease. The course was also complicated by cutaneous necrotizing vasculitis. Further deterioration occurred after a relapse of pulmonary infection, and she died following acute abdominal surgery for perforated sigmoiditis. It is speculated that the clinical course was in part caused by polyclonal B-cell activation.
我们报告了一例76岁女性患者，其出现血清阳性类风湿关节炎的发作呈复发型。在遭受暴发性肺部感染后，她接受了针对鹦鹉热、支原体、卡氏肺孢子虫和低滴度耶尔森菌的血清学检测。类风湿因子滴度也升高，抗核抗体检测呈阳性。临床上，原本较为良性的多关节炎病程转变为快速进展的变形性疾病。病程还并发了皮肤坏死性血管炎。肺部感染复发后病情进一步恶化，她在因乙状结肠穿孔接受急性腹部手术后死亡。据推测，临床病程部分是由多克隆B细胞活化引起的。
