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[血清阳性多关节炎作为血管免疫母细胞性淋巴结病的一种表现形式]

[Seropositive polyarthritis as a presentation form of angioimmunoblastic lymphadenopathy].

作者信息

Bistué R, Scognamillo C, Lovato G, Parra G, Maddio J, Roselli G

机构信息

Departamento de Medicina Interna, Universidad Nacional de Cuyo, Hospital Central, Mendoza, Argentina.

出版信息

Medicina (B Aires). 1993;53(5):435-8.

PMID:8201932
Abstract

We present a 59-year-old male who was admitted due to fever and generalized lymphadenopathy. The patient had polyclonal hypergammaglobulinemia, Coombs-positive anemia, positive rheumatoid factor (latex 1:1280-SCAT 1:128), hypocomplementemia, negative LE cells and FAN negative. He had a 2 months history of a rheumatoid arthritis-like polyarthritis with poor response to non-steroid antiinflammatory drugs. On physical examination a mild symmetrical polyarthritis of small and large joints was seen. A lymph node biopsy showed architectural effacement, absence of germinal centers, arborization of postcapillary venules and a polymorphonuclear infiltrate that included immunoblasts. Thus, this patient fulfills the morphologic criteria of angioimmunoblastic lymphadenopathy (AILD) (Fig. 1 and 2). Our purpose was to describe the association of seropositive polyarthritis with AILD as a presentation sign. Whether this represents a case of a rheumatoid arthritis with AILD or the polyarthritis which has been described as part of the clinical picture or AILD is difficult to say due to the short time evolution of the disease.

摘要

我们报告一例59岁男性,因发热和全身淋巴结肿大入院。该患者有多克隆高球蛋白血症、抗人球蛋白试验阳性的贫血、类风湿因子阳性(乳胶凝集试验1:1280 - 散射比浊法1:128)、补体血症、狼疮细胞阴性和抗核抗体阴性。他有2个月类风湿关节炎样多关节炎病史,对非甾体抗炎药反应不佳。体格检查发现大小关节有轻度对称性多关节炎。淋巴结活检显示结构消失、生发中心缺如、毛细血管后微静脉分支形成以及包括免疫母细胞在内的多形核浸润。因此,该患者符合血管免疫母细胞性淋巴结病(AILD)的形态学标准(图1和图2)。我们的目的是描述血清学阳性多关节炎与AILD作为一种表现体征之间的关联。由于疾病病程较短,很难说这是一例合并AILD的类风湿关节炎,还是已被描述为AILD临床表现一部分的多关节炎。

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