成年人的迁移性关节炎和心脏阻塞:一个被遗忘的诊断重新回顾
Marius Dsouza1, Boon J San1, Suraj Adhikari1
1Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.
Cureus
|September 19, 2025
概括
急性类风湿性发烧 (ARF),在成年人中很少见,可以与迁移性关节炎和亚临床心脏炎一起出现. 早期诊断和治疗对于预防长期心脏并发症至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 急性类风湿性发烧 (ARF) 是对A组链球菌 (GAS) 的免疫反应.
- ARF主要影响儿童,成人病例很少见.
- 心炎是ARF在成年人中不常见的表现.
研究的目的:
- 在35岁的男性中呈现一种罕见的ARF病例.
- 突出成人ARF的临床表现,包括关节炎和亚临床心脏炎.
- 在这个人口群体中强调ARF的诊断标准和管理.
主要方法:
- 一个35岁的男性患有发烧和迁移性多关节炎的病例报告.
- 诊断工作包括心声回声,红细胞沉积率 (ESR) 和抗斯特雷普托利辛O (ASO) 标位.
- 根据2015年修订的斯标准进行诊断.
主要成果:
- 这位患者出现了迁移性多关节炎,发烧,延长PR间隔,轻度大动脉吐和痕迹腹吐.
- 升高的ESR (101毫米/小时) 和高的ASO标位 (1,600 IU/mL) 支持了诊断.
- 患者对NSAIDs和青素G反应良好,并开始终身阿齐思罗米辛预防.
结论:
- 在患有迁移性关节炎和导电异常的成年患者中应考虑ARF.
- 亚临床心炎可能是成年人ARF的表现.
- 遵守诊断标准和适当的管理对于ARF患者至关重要.
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