在与皮质类固醇和DMARDs治疗的类风湿性关节炎中的无菌性pyomyositis
Sudhir Karmacharya1, Adheep Arun Shrestha1, Shweta Nakarmi1
1Rheumatology Department, National Center for Rheumatic Diseases, House no 158, Pashupati Sadak, Kathmandu-9, 44600, Nepal.
Oxford medical case reports
|June 11, 2024
概括
本案例研究突出了自身免疫性肌肉炎,一种罕见的无菌肌肉感染,在类风湿性关节炎患者. 治疗包括皮质类固醇,疾病修饰性抗风湿药物和手术排水导致完全康复.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 肌肉骨系统疾病 肌肉骨系统疾病
背景情况:
- 肌肉炎是一种骨肌肉的细菌感染,通常在热带地区出现.
- 麻醉性肌肉炎是一种罕见的变体,其特点是无菌的形成,对健康构成重大风险.
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,主要影响关节,但可以有关节外的表现.
研究的目的:
- 在患有血清阳性类风湿性关节炎的患者中报告一种罕见的自身免疫性肌肉炎病例.
- 描述这种复杂疾病的诊断方法和成功管理.
- 强调在肌肉炎中考虑自身免疫病因的重要性,特别是在患有自身免疫疾病的患者中.
主要方法:
- 一个53岁的女性患有类风湿性关节炎的病例介绍.
- 临床评估,包括身体检查,检查小腿疼痛和胀.
- 诊断工作排除感染原因并确认自身免疫性肌肉炎.
- 治疗方案包括口服普雷迪尼索隆,常规合成疾病修饰性抗风湿药物 (csDMARDs) 和手术性排液.
主要成果:
- 患者出现了右小腿疼痛和胀,最初怀疑是传染性肌肉炎.
- 诊断证实为类风湿性关节炎与自身免疫性肌肉炎,不包括感染原因.
- 用皮质类固醇,csDMARDs (甲托雷克萨特,莱夫卢诺米德,氧化) 和手术排水的治疗导致肌肉病变的完全消失.
- 患者在3个月内实现了原发性类风湿性关节炎疾病的缓解.
结论:
- 自身免疫性肌肉炎可以发生在类风湿性关节炎患者中,并呈现为无菌肌肉.
- 结合免疫抑制疗法和手术干预的多学科方法是有效的.
- 早期诊断和适当的治疗对于与RA相关的自身免疫性肌肉炎的良好结果至关重要.
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