麻风病,风湿性疾病的伟大模仿者:一个案例研究
Haidy Youssef1, Tandis Mahani2, Mehrnaz Hojjati3
1Rheumatology and Internal Medicine, Riverside Medical Clinic, Temescal Valley, USA.
Cureus
|June 28, 2023
概括
本案例研究描述了一名最初被诊断为混合结合组织疾病的患者,后来被发现患有极性病. 早期诊断麻风对于有效治疗皮肤血管炎至关重要.
科学领域:
- 皮肤病学 皮肤病学
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 皮肤血管炎可能伴有不愈合的,模仿系统性类风湿病.
- 混合结合组织疾病 (MCTD) 可能具有与其他自身免疫性疾病重叠的特征.
- 麻风病,特别是极性麻风病,可以表现为各种皮肤症状.
研究的目的:
- 报告一个皮肤血管炎的病例,最初被误诊为MCTD.
- 突出病模仿类风湿病所带来的诊断挑战.
- 强调在耐火性皮肤病症中考虑感染病因的重要性.
主要方法:
- 患者在10年的病史中出现了下肢和红血斑块.
- 基于临床表现和血清学标记 (阳性U1-RNP,ANA) 的MCTD初步诊断.
- 随后的皮肤活检显示了颗粒瘤和酸性快速生物体,导致PCR识别了Mycobacterium lepromatosis*.
主要成果:
- 患者的病情,最初被称为MCTD治疗,显示复发性.
- 第三次皮肤活检确定了 * Mycobacterium lepromatosis * ,诊断出带红斑结节的极性.
- 三个月的米诺环素和利法治疗导致和红血完全消失.
结论:
- 麻风病可以潜伏地呈现,模仿诸如MCTD之类的全身性类风湿病.
- 持续的,无法解释的皮肤病变需要彻底调查感染原因.
- 及时诊断和适当的抗菌药物治疗对于治疗麻风引起的血管炎至关重要.
相关概念视频
01:23Rheumatic Heart Disease I: Introduction
17
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
17
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38
01:29Pulmonary Tuberculosis I
286
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
286
01:28Pulmonary Tuberculosis II
281
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
281
01:31Pulmonary Tuberculosis III
381
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
381
01:28Pulmonary Tuberculosis V
214
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
214