由于微观多炎的原因,舌头肌化
Alfiya Gali1, Tasnia Rahman2, Pia Sumbly3
1Department of Medicine, McGill University Faculty of Medicine, Montreal, Quebec, Canada alfiya.gali@mail.mcgill.ca.
BMJ case reports
|October 8, 2025
概括
一个罕见的女性舌头肌化病病例与肌氧化酶抗中性粒细胞质抗体相关的血管炎有关. 治疗导致病变的解决和抗体的正常化,改善症状.
科学领域:
- 神经学 神经学
- 类风湿病学 类风湿病学
- 血管医学 血管医学
背景情况:
- 舌头肌化病可以呈现出不寻常的神经症状.
- 血管炎,特别是抗MPO-ANCA相关的血管炎 (MPA),可以影响头骨神经和血管.
- 由于罕见的呈现和避免活检的需要,诊断可能具有挑战性.
研究的目的:
- 报告MPO-ANCA相关的血管炎引起的舌头肌化病病例.
- 为了说明一个活检是禁忌的患者的诊断和治疗方法.
- 突出免疫抑制疗法在解决血管性病变和改善症状方面的有效性.
主要方法:
- 舌头肌化学的临床表现.
- 磁共振成像 (MRI) 用于解剖评估.
- 对抗myeloperoxidase抗中性粒细胞体抗体 (anti-MPO-ANCA) 的血清检测.
- 免疫抑制治疗方案包括皮质类固醇,环胺和阿扎西奥普林.
主要成果:
- 核磁共振扫描显示,软组织质量压缩了下神经和内动脉.
- 阳性抗MPO-ANCA抗体支持了MPA的诊断.
- 治疗导致MRI上病变的完全消失和抗MPO抗体的正常化.
- 显著,虽然不是完整的,在舌头神经瘤的改善被观察到.
结论:
- 抗MPO-ANCA相关的血管炎可以表现为由于神经压缩而导致的舌头肌化学.
- 影像,血清学和免疫抑制反应的组合可以帮助诊断当活检是不可行的.
- 积极的免疫抑制疗法可以导致影响骨结构的MPA的良好结果.
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