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移植后的新发性系统性红斑性狼:病例报告
Alexandra Esteves1, Andreia Henriques1, Beatriz Fernandes1
1Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Transplantation proceedings
|August 14, 2025
概括
在移植患者中诊断新的自身免疫性疾病是困难的. 本病例报告详细介绍了一例罕见的新发性系统性红斑狼 (SLE) 病例,在移植后9年发展,特别是在没有脏参与的情况下.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 在移植患者中诊断新的自身免疫性疾病存在重大挑战.
- 移植后新发的系统性红斑狼 (SLE) 异常罕见,报告的病例有限.
研究的目的:
- 在移植接受者中报告一种罕见的新发性SLE病例.
- 突出诊断挑战和移植后SLE的独特呈现,没有脏参与.
主要方法:
- 一个移植患者的案例研究,在移植后9年出现非特异性炎症症状.
- 诊断工作包括免疫检测 (ANA,抗dsDNA抗体,β-2微球蛋白) 和功能和尿液沉积物的评估.
- 通过使用EULAR/ACR 2019标准对SLE的诊断得到确认.
主要成果:
- 患者出现了发烧,腹,迁移性多关节痛,肌痛,和皮疹.
- 免疫测试对ANA,抗dsDNA抗体和升高的β-2微型球蛋白呈阳性.
- 最重要的是,该患者没有表现出脏干扰的迹象,保持稳定的功能和正常的尿液沉积物.
- 用皮质类固醇和贝利穆马布治疗在10个月内导致部分临床和血清学改善.
结论:
- 这一案例突显了移植后新发性SLE的罕见表现,其特点是缺少参与.
- 对于移植接受者表现出暗示自身免疫性疾病的非特异性炎症症状,高度的怀疑指数是必不可少的.
- 早期诊断和适当的管理,包括像贝利马布这样的新疗法,可以带来更好的结果.
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