类风湿性关节炎和心周溢血 - - 一个独特的主要表现
Isabel Cruz1, Bruno Bragança1, Rafaela Lopes1
1Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal.
European journal of case reports in internal medicine
|February 14, 2024
概括
类风湿性关节炎 (RA) 仅以心周溢出形式表现,即使没有关节症状. 经常发生的心周溢出需要在诊断时考虑RA,特别是当其他症状不存在时.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
背景情况:
- 心周溢血是风湿性关节炎 (RA) 的已知并发症.
- 然而,它很少表现为RA的最初或唯一表现.
- 关节炎的关节外表现可以在没有关节症状之前发生或发生.
研究的目的:
- 突出诊断的挑战是心周溢血作为类风湿性关节炎的第一个表现.
- 强调在对复发性心周溢血的差异诊断中考虑RA的重要性,即使没有关节疼痛.
主要方法:
- 一个82岁的男性病例报告,患有复发性心周溢血.
- 诊断工作包括成像 (CT,心声),广泛的血清学测试 (风湿因子,抗CCP抗体) 和心周液分析.
- 治疗包括免疫调节疗法和手术干预 (肺周心脏窗口).
主要成果:
- 该患者出现了暗示感染的症状,但被发现具有高的类风湿因子和抗CCP抗体.
- 在初始治疗后心周溢血复发,导致手术干预.
- 心周组织的组织病理学显示出与RA一致的炎症变化.
结论:
- 心周溢出可能是类风湿性关节炎的主要和唯一的表现.
- 风湿性关节炎应考虑在复发性心周输液的病因调查中,无论是否存在关节症状.
- 早期诊断和治疗与RA相关的心周输液至关重要.
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