[具有自身免疫性肝炎的慢性非细菌性骨髓炎:病例报告和文献综述]
1Department of Gastroenterology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua er ke za zhi = Chinese journal of pediatrics
|June 29, 2023
概括
慢性非细菌性骨髓炎可以影响肝脏,在儿童中呈现为自身免疫性肝炎. 葡萄糖皮质激素治疗有效治疗这种罕见的疾病,改善症状和肝功能.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 儿科胃肠病学 儿科胃肠病学
- 儿童传染病 儿童传染病
背景情况:
- 慢性非细菌性骨髓炎 (CNMO) 是一种罕见的炎症性骨病.
- 自免疫性肝炎 (AIH) 是一种自免疫性起源的慢性肝病.
- 儿童中CNMO和AIH的同时发生非常罕见,报告的病例有限.
研究的目的:
- 总结诊断为患有慢性非细菌性骨髓炎和自身免疫性肝炎的儿科患者的临床特征和治疗方法.
- 分析这种罕见的双重诊断的表现,诊断挑战和治疗结果.
主要方法:
- 一个被诊断为CNMO和AIH的单个儿科病例的回顾性分析.
- 在英语和中文数据库 (CNKI,Wanfang,CBM,PubMed) 中使用关键词"慢性非细菌性骨髓炎"和"自身免疫性肝炎"进行全面的文献搜索,截至2022年12月.
- 综合分析所介绍的病例与先前报告的病例,以确定共同特征和治疗反应.
主要成果:
- 一个5岁的女孩呈现出高的转氨酶和大面部胀,诊断出AIH和CNMO影响下.
- 实验室发现包括肝功能异常,IgG升高,抗核和抗平滑肌抗体阳性,以及肝活检结果的特征.
- 文献审查发现只有一个先前报告的病例,也是一名女性,关节疼痛是主要症状;这个病例最初涉及肝脏.
- 这两种病例均显示,在葡萄糖皮质激素治疗后,临床症状显著改善,肝酶正常化.
结论:
- 慢性非细菌性骨髓炎可以出现肝脏参与,模仿自身免疫性肝炎.
- 在儿科病例中,葡萄糖皮质激素治疗在治疗骨髓炎和自身免疫性肝炎组件方面都表现出有效性.
- 需要进一步的研究,以了解潜在的病理生理学,并优化对这种罕见的并发症的管理策略.
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