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患有抑郁症的自闭症患者中多质炎的粒状瘤:诊断和管理方面的挑战
Aashir Javed1, Sviatlana Zhyzhneuskaya2, Narmeen Khalid3
1General Internal Medicine, University Hospital of North Durham, Durham, GBR.
Cureus
|December 6, 2024
概括
这项案例研究强调考虑自免疫性疾病,如与多炎 (GPA) 相结合的颗粒体病,在出现多系统症状的自闭症患者中. 早期诊断和适当的治疗对于管理这种罕见的疾病至关重要.
科学领域:
- 内部医学 内部医学
- 类风湿病学 类风湿病学
- 神经学 神经学
背景情况:
- 自闭症谱系障碍 (ASD) 和抑郁症是常见的并发症.
- 自身免疫性疾病可以呈现出多种多系统性症状.
- 带有多叶膜炎 (GPA) 的粒状瘤炎是一种罕见的自身免疫性血管炎.
研究的目的:
- 在一个患有自闭症和抑郁症的成年男性中报告一个带有多炎 (GPA) 的颗粒瘤病例.
- 突出GPA的诊断挑战和多系统表现.
- 强调在患有自闭症和复杂表现症的患者中考虑自身免疫性疾病的重要性.
主要方法:
- 一个30多岁的男性患者的病例报告,患有自闭症和抑郁症.
- 临床表现包括关节疼痛,皮疹,血和表.
- 诊断工作包括炎症标志物,成像 (胸部X射线,CT胸部) 和血清学测试 (抗蛋白酶3抗体).
主要成果:
- 最初的呈现模仿感染,导致经验性抗生素和类固醇.
- 尽管接受了治疗,但炎症标志物的增加促使进一步调查.
- 通过阳性抗蛋白酶3抗体和特征CT发现,GPA的诊断得到了证实.
- 患者在使用广谱抗生素,类固醇和rituximab时显示出临床改善.
结论:
- 在患有不明原因的多系统性症状的自闭症患者的差异诊断中应考虑GPA.
- 早期识别和管理GPA对于有利的结果至关重要.
- 这一案例强调了对复杂患者群体的综合诊断方法的需要.
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