伪装成风湿病的血液恶性瘤:一个病例系列和综述
Julia Clark1, Makshada Kowlessur2, Elysha VanderVeer3
1Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Medicine
|April 28, 2025
概括
血液性恶性瘤可以模仿类风湿性疾病,导致诊断延迟. 在患有异常类风湿症状的患者中,早期考虑癌症对于及时治疗和改善结果至关重要.
科学领域:
- 血液学 血液学 血液学
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
背景情况:
- 血液性恶性瘤经常出现与类风湿病症重叠的症状,这给诊断带来了挑战.
- 这项研究检查了5个案例,其中血液癌模仿了类风湿病,突出了诊断复杂性.
研究的目的:
- 调查血液恶性瘤的诊断挑战和临床表现,伪装成类风湿病.
- 强调在耐火性或非典型的类风湿病的差异诊断中考虑恶性瘤的重要性.
主要方法:
- 五名患者 (年龄在64-78岁之间) 的回顾性审查,血液恶性瘤呈现为类风湿性疾病.
- 临床特征分析,包括实验室检测,成像和骨髓活检在内的诊断工作,以及治疗结果.
主要成果:
- 患者呈现出各种类型的类风湿症状 (多关节炎,血管炎,雷诺现象) 和全身症状 (减肥,疲劳).
- 最初的评估表明了类风湿病的诊断,导致诊断延迟. 骨髓活检证实了各种血液恶性瘤 (AITL,外节边缘区域淋巴瘤,MDS,多发性骨髓瘤).
- 结果各不相同,一些患者对向治疗有反应,而另一些患者则面临疾病进展,并发症或死亡. 诊断延迟对治疗和结果产生了负面影响.
结论:
- 在非典型或耐火性类风湿病的差异诊断中,应考虑血液性恶性瘤.
- 在患有异常表现或血清学/组织病理学发现暗示癌症的患者中,对恶性瘤的警至关重要.
- 及时诊断和启动恶性瘤特异性疗法对于改善患者预后和结果至关重要.
相关概念视频
The JAK-STAT Signaling Pathway
8.4K
Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as SH2...
8.4K
Autoimmune Disorders
313
Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
Concept and Mechanism of Autoimmune Diseases
The immune...
Concept and Mechanism of Autoimmune Diseases
The immune...
313
Regulation of Hematopoietic Stem Cells
3.1K
All blood and immune cells are produced from the multipotent hematopoietic stem cells (HSCs) by the process of hematopoiesis. However, they all have a limited life span. In addition, many are depleted in immune surveillance or combatting an injury or infection. This makes blood one of the most regenerative tissues. Hematopoiesis helps replenish these blood and immune cells, restoring the body's normal functioning. However, overproduction of blood and immune cells can make them cancerous or...
3.1K
Bone Marrow Sampling and Transplants
260
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
260
T Cell Types and Functions
615
When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
615


