成人发病的模仿肌肉炎的病:一个病例报告
Mario B Prado1, Karen Joy B Adiao2
1Department of Physiology, University of the Philippines Manila, Manila, PHL.
Cureus
|January 27, 2025
概括
成年开始的斯蒂尔病 (AOSD) 可以模仿年轻成年人的肌肉炎. 高水平的费里是诊断AOSD的关键,避免了昂贵的肌炎手术.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 神经学 神经学
背景情况:
- 肌肉炎通常在患有严重肌痛,虚弱和出血症的患者中被怀疑.
- 肌肉破坏引起的肌球蛋白尿症会导致红色的尿液.
- 成人发病的斯蒂尔病 (AOSD) 提出了诊断挑战,特别是在正常肌酸激酶的年轻患者中.
研究的目的:
- 突出考虑AOSD在呈现与肌肉炎重叠症状的患者的差异诊断中的重要性.
- 强调血清费里水平在识别AOSD和避免不必要的研究肌肉炎的诊断实用性.
主要方法:
- 一个25岁的菲律宾男性的病例报告,一个月的逐渐减弱,关节疼痛,皮疹,发烧,出血和食欲丧失.
- 在甲基prednisolone脉冲疗法 (MPPT) 之前和之后监测C反应蛋白 (CRP) 和红细胞沉率 (ESR).
- 评估血清费里水平以帮助诊断.
主要成果:
- 患者出现了模仿肌肉炎的症状,包括虚弱和出血症.
- 观察到CRP和ESR水平升高,在MPPT后持续存在.
- 非常高的血清费里水平 (1675.56 ug/L) 对于确认AOSD的诊断至关重要.
结论:
- 在患有不明原因的虚弱,肌痛和出血症的年轻患者中,AOSD应成为首要考虑因素,特别是当肌酸酶正常时.
- 血清费里含量升高是AOSD的高度敏感标志物,有助于早期诊断,并防止为肌肉炎进行昂贵的侵入性治疗.
- 及时诊断AOSD具有成本效益和临床益处,避免不必要的抗体测试和肌肉活检与肌肉炎评估相关.
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