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一个常被忽视的临床实体:一个病例报告

Anita Tudu¹, Sourav Paul², Udas C Ghosh³

¹Junior Resident, Department of General Medicine, Medical College, Kolkata, West Bengal, India, Corresponding Author.

The Journal of the Association of Physicians of India

|November 26, 2025

概括

反中性细胞质抗体 (ANCA) 相关的血管炎可以在没有ANCA抗体的情况下发生. 这一案例突出了通过临床表现和脏活检诊断ANCA负的免疫性球腺炎的诊断,脏活检,成功地用rituximab治疗.

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:

抗中性粒细胞体抗体 (ANCA) 相关的血管炎 (AAV) 经常影响脏,通常呈现为乳腺免疫质炎 (PIGN).
一个重要的亚组 (10-40%) 的AAV患者是ANCA阴性,呈现出明显的临床特征和潜在的轻度疾病.
诊断ANCA阴性PIGN依赖于临床怀疑和缺少血清学标记的组织病理学证据.

研究的目的:

为了呈现一种ANCA阴性免疫性血管炎的病例.
强调ANCA阴性PIGN的诊断挑战和方法.
为了说明在血清阴性血管炎病例中的成功治疗结果.

主要方法:

一个58岁的男性发烧,出血和紫外线的临床病例介绍.
对ANCA的血清测试是负的.
脏活检用于对乳腺病理学诊断的乳腺免疫性丸炎.

主要成果:

患者表现出与血管炎一致的症状,但对ANCA的检测结果为负.
脏活检证实了乳腺免疫性血球炎,从而诊断出ANCA阴性血管炎.
患者对Rituximab治疗反应良好.

结论:

阴性ANCA-PAUCI-IMMUNE GLOMERULONEPHRITIS在AAV中是一个独特的实体,需要仔细的临床和病理评估.
尽管ANCA血清学呈阴性,但通过临床表现和脏活检的结合,可以实现诊断.
利图西马布可以成为ANCA阴性乳腺免疫血管炎的有效治疗选择.

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