ANA阴性严重狼状呈现:这是狼还是不是?
1Department of Nephrology Changhai Hospital, The Navy Medical University Shanghai China.
Clinical case reports
|November 15, 2023
概括
在缺乏典型症状的ANA阴性患者中,诊断严重的系统性红斑狼 (SLE) 是一个挑战. 这一案例凸显了在严重的ANA阴性狼样症状中组织学发现的诊断价值.
科学领域:
- 类风湿病学 类风湿病学
- 腎臟病學 (nephrology) 是一種醫學.
- 自体免疫学 自体免疫学
背景情况:
- 系统性红斑狼 (SLE) 是一种自身免疫性疾病,通常与抗核抗体 (ANA) 等自身抗体有关.
- 一小部分SLE患者表现出负的ANA,但这些病例通常是轻微的,不涉及多个器官系统.
- 严重的SLE与持续负的ANA和非典型的临床表现仍未得到充分研究.
研究的目的:
- 在患有持续负面ANA和非典型临床特征的患者中呈现严重狼类表现的病例.
- 讨论在这种情况下的诊断挑战和组织学发现的作用.
主要方法:
- 一个34岁的中国妇女的病例报告,患有严重的狼样症状.
- 临床评估,包括评估典型的SLE症状 (疟疾皮疹,光敏感性等). ) 的情况.
- 脏活检用于组织病理学检查.
主要成果:
- 该患者出现了严重的症状,包括功能衰竭,血清腔和,但缺乏常见的SLE临床症状.
- 包括ANA,anti-Smith和anti-dsDNA在内的自身抗体测试始终是负的.
- 脏活检揭示了狼性炎,支持SLE的诊断,尽管有负面的血清学和非典型的呈现.
结论:
- 严重的系统性红斑狼可以发生在缺乏典型的临床表现的ANA阴性个体中.
- 组织学发现,特别是活检,对于在模两可的情况下诊断SLE至关重要.
- 这一案例强调了诊断方面的挑战,以及在疑似SLE患者中,除了血清学标志物之外,需要进行全面的评估.
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