类风湿性关节炎中反应性囊细胞扩散模仿埃尔德海姆-切斯特病
Syed Mashood Iqbal1, Abrar Ali Mohammed2, Mudasir R Ghani3
1Acute and General Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, GBR.
Cureus
|September 24, 2025
概括
埃尔德海姆-切斯特病 (ECD) 可以模仿类风湿性关节炎 (RA). 这一案例表明RA中的反应性囊细胞瘤如何表现为ECD,强调需要仔细诊断.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 埃尔德海姆 - 切斯特病 (ECD) 是一种罕见的囊细胞形成,由于其模仿炎症和瘤状况,因此存在诊断挑战.
- 囊细胞增殖和关节干扰可能会使ECD和其他疾病之间的差异化变得复杂.
研究的目的:
- 突显区分埃尔德海姆 - 切斯特病与具有反应性细胞瘤的类风湿性关节炎的诊断困难.
- 强调综合评估的重要性,包括复杂病例的遗传检测.
主要方法:
- 一个成年女性患有多关节性关节疼痛,呼吸障碍和胸腔溢液的案例介绍.
- 使用成像 (FDG PET-CT),胸腔镜,肺部活检,血清学 (RF,抗CCP) 和遗传检测.
- 对类风湿性关节炎的甲索特雷克萨特治疗的评估反应.
主要成果:
- 由于在肺部活检中发生的囊细胞增殖,最初怀疑ECD.
- 通过临床表现和血清学标记 (RF>200 U/mL,抗CCP>340 U/mL) 确认了类风湿性关节炎的诊断.
- 活检中缺少突变排除了ECD,支持反应性囊细胞瘤;患者通过甲状腺酸改善.
结论:
- 区分ECD和RA与反应性细胞瘤需要仔细考虑临床,血清学和遗传发现.
- 多学科评估和基因检测对于对具有挑战性的囊细胞疾病进行准确诊断和管理至关重要.
相关概念视频
Rheumatic Heart Disease I: Introduction
447
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
447
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
492
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
492
T Cell Types and Functions
2.2K
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...
2.2K
Cardiomyopathy IV: Restrictive Cardiomyopathy
455
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
455
Endocarditis II: Clinical Features of Infective Endocarditis
421
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
421
Myocarditis II: Clinical Features and Diagnostic Tests
267
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
267

