聚关节炎最初呈现为眼部运动障碍和双眼视,随后发展为双边中央视网膜动脉封闭:一个病例报告
Suguru Nakagawa1, Shigeo Akiyama2, Shuji Hino2
1Department of Ophthalmology, Saitama Red Cross Hospital, Saitama, Japan.
American journal of ophthalmology case reports
|February 4, 2025
概括
聚关节炎 (PAN) 是一种罕见的血管炎,最初可能会出现眼睛运动问题,并导致视力丧失,原因是中枢视网膜动脉封闭 (CRAO). 早期的PAN诊断对于预防严重并发症至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 内部医学 内部医学
背景情况:
- 多关节炎 (PAN) 是一种系统性血管炎,影响中小动脉.
- 眼部表现,虽然有多样性,但通常不是PAN的初始表现.
研究的目的:
- 报告一个独特的PAN病例,最初呈现眼动力障碍和双眼视.
- 为了突出双边中央视网膜动脉封闭 (CRAO) 的后续发展,作为PAN的罕见眼部表现.
主要方法:
- 一个58岁的男性的病例报告,最初的症状是双眼视和眼动力受损.
- 诊断工作包括眼科检查,IgG4水平, fundus光素血管造影和腹腔切除以检查肠道穿孔.
- 通过在中小动脉中发现血管炎来确认PAN的诊断.
主要成果:
- 患者最初呈现出双眼视和眼动力问题,怀疑是IgG4相关的轨道肌炎.
- 发展了双边的视网膜中枢动脉封闭 (CRAO),导致显著的视力丧失.
- 在肠道穿孔术后确认了PAN诊断,揭示了特征性血管炎.
结论:
- 眼动力障碍和双眼视可能是PAN的早期迹象,即使没有经典的全身症状.
- PAN可以迅速发展为严重的视力障碍,包括双边CRAO.
- 由于PAN的严重并发症和不良预后,早期识别和治疗至关重要.
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