Ozaki Y, Kagawa H, Yasuzawa M, Yoshimura C, Shimizu T, Nomura S, Kitajima H, Kishimoto Y, Komiyama Y, Okamura A, Fukuhara S
First Department of Internal Medicine, Kansai Medical University.
Rinsho Ketsueki. 1998 Jun;39(6):436-41.
A 22-year-old woman was admitted to our hospital with fever, generalized lymphadenopathy, and pancytopenia in February 1995. She was diagnosed as having systemic lupus erythematosus (SLE) based on positivity for anti-nuclear antibody, and polyarthritis among other findings. A diagnosis of disseminated intravascular coagulation (DIC) was made based on the increase of FDP and other data (DIC score: 7). We also detected an anti-fibrinogen antibody. Lymph node biopsy revealed subacute necrotizing inflammation and there were on signs of the hemophagocytic phenomenon in bone marrow. The DIC score improved and the anti-fibrinogen antibody disappeared in association with the response of SLE to prednisolone therapy. The onset of SLE associated with DIC has never been reported before, as far as we could determine. The mechanism of DIC associated with SLE may be related to endothelial damage caused by immune complexes.
1995年2月,一名22岁女性因发热、全身淋巴结肿大和全血细胞减少症入住我院。根据抗核抗体阳性及多关节炎等表现,她被诊断为系统性红斑狼疮(SLE)。基于纤维蛋白降解产物(FDP)升高及其他数据(DIC评分:7),诊断为弥散性血管内凝血(DIC)。我们还检测到了抗纤维蛋白原抗体。淋巴结活检显示为亚急性坏死性炎症,骨髓中无噬血细胞现象迹象。随着SLE对泼尼松治疗产生反应,DIC评分改善,抗纤维蛋白原抗体消失。据我们所知,此前从未有过SLE合并DIC发作的报道。SLE相关DIC的机制可能与免疫复合物导致的内皮损伤有关。