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[结节性多动脉炎一例的诊断难点]

[Diagnostic difficulties in a case of polyarteritis nodosa].

作者信息

Oworuszko D, Witczak W, Szubstarski F

机构信息

Oddziału Chorób Wewnetrznych Szpitala Wojskowego w Lublinie.

出版信息

Wiad Lek. 1993 Sep;46(17-18):700-3.

PMID:7975609
Abstract

A case of polyarteritis nodosa is presented in view of diagnostic difficulties which it caused. In a 47-year-old patient, in the clinical picture the following predominated: paroxysmal abdominal pain, symptoms and signs of polyneuropathy, and paralysis of the left peroneal and left radial nerves. Besides that, hypertension, tachycardia, sub-febrile states, significant body weight loss, and skin lesions were observed. In laboratory investigations high ESR, leucocytosis, HBe antigenaemia with the presence of all antibodies, and significant hypergammaglobulinaemia were found. In the differentiation, apart from polyarteritis nodosa, the following was taken into account: porphyria, neoplastic abdominal diseases with polyneuropathy, neurological diseases. Of decisive importance for making the diagnosis was microscopic examination of calf muscle biopsy specimen.

摘要

鉴于结节性多动脉炎引发的诊断困难,现呈现一例该病症。一名47岁患者,临床表现以阵发性腹痛、多发性神经病变的症状和体征以及左侧腓总神经和左侧桡神经麻痹为主。除此之外,还观察到高血压、心动过速、低热状态、明显体重减轻以及皮肤病变。实验室检查发现血沉加快、白细胞增多、HBe抗原血症且所有抗体均呈阳性,以及显著的高丙种球蛋白血症。在鉴别诊断中,除结节性多动脉炎外,还考虑了以下疾病:卟啉病、伴有多发性神经病变的腹部肿瘤性疾病、神经疾病。对做出诊断起决定性作用的是小腿肌肉活检标本的显微镜检查。

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