多肌痛性风湿病例的诊断困难与正常的红细胞沉积率和C-反应蛋白值
Mete Kara1, Gülay Alp2, Ali Murat Koç3
1University of Health Sciences Izmir Bozyaka Research and Training Hospital, Rheumatology Department, Izmir, Turkey.
Medicine
|September 29, 2023
概括
多发性肌痛性风湿症 (PMR) 可以呈现出正常的红细胞沉积率 (ESR) 和C反应蛋白 (CRP) 水平. 在这些情况下,通过超声波辅助诊断证实了血清粉样蛋白A (SAA) 和疹炎的升高.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 诊断医学 诊断医学 诊断医学
背景情况:
- 多发性肌痛风湿症 (PMR) 诊断依赖于临床表现,因为缺乏特定的测试.
- 红细胞沉积率 (ESR) 和C反应蛋白 (CRP) 是常见的急性相反应剂 (APR),用于PMR诊断和监测.
研究的目的:
- 在临床诊断的PMR患者中调查正常ESR和CRP的发生率.
- 确定PMR患者正常ESR和CRP的临床特征.
主要方法:
- 在单一中心对54名临床诊断的PMR患者进行了回顾性审查.
- 超声波用于确认正常ESR和CRP的患者的囊炎.
- 在PMR患者中,正常与升高ESR/CRP水平之间的临床特征的比较.
主要成果:
- 54名 (14%) PMR患者中有8名表现出正常的ESR和CRP水平.
- 所有正常ESR/CRP的患者都显示血清粉样蛋白A (SAA) 水平升高.
- 患有正常ESR/CRP的PMR患者在诊断时年轻,症状持续时间较长,并具有较低的并发症率.
结论:
- 即使正常的ESR和CRP值,PMR诊断也是可能的.
- 在这些情况下,超声波确认的炎是关键的发现.
- 当ESR和CRP正常时,升高的SAA水平可以作为替代生物标志物.
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