Azais I, Lambert de Cursay G, Deblais F, Deschamps O, Gandon P, Alcalay M, Bontoux D
Service de Rhumatologie, CHRU Poitiers.
Rev Rhum Ed Fr. 1993 Mar;60(3):240-4.
A 66 year old Corsican HLA A2 and DR5-positive male with moderately active seropositive destructive rheumatoid arthritis developed Kaposi's sarcoma after intraarticular administration of corticosteroids. He had no history of oral corticosteroid therapy, organ transplantation, AIDS, or cancer. Chlorambucil proved ineffective but the outcome was spontaneously favorable following discontinuation of oral corticosteroid therapy initiated after the development of the skin lesions. Six previous reports of concomitant rheumatoid arthritis and Kaposi's sarcoma were found. All six cases occurred following systemic corticosteroid therapy. The high incidence of rheumatoid arthritis and the small number of patients with rheumatoid arthritis and Kaposi's sarcoma suggest that concomitant occurrence of the two conditions may be fortuitous. However, the responsibility of corticosteroid therapy, which preceded development of Kaposi's sarcoma in every case, cannot be ruled out.
一名66岁的科西嘉男性,HLA A2和DR5呈阳性,患有中度活动的血清阳性破坏性类风湿性关节炎,在关节内注射皮质类固醇后发生了卡波西肉瘤。他没有口服皮质类固醇治疗、器官移植、艾滋病或癌症病史。苯丁酸氮芥治疗无效,但在皮肤病变出现后开始的口服皮质类固醇治疗停止后,病情自发好转。此前发现了6例类风湿性关节炎与卡波西肉瘤并存的报告。所有6例均发生在全身皮质类固醇治疗之后。类风湿性关节炎的高发病率以及类风湿性关节炎与卡波西肉瘤患者数量较少表明,这两种疾病同时发生可能是偶然的。然而,在每例卡波西肉瘤发生之前都有皮质类固醇治疗,因此不能排除其责任。