脚坏死:一个令人惊的先驱的抗中性质细胞质抗体与血管炎相关的抗中性质细胞质抗体
Anil Regmi1, Payal Shukla1, Pragya Karki2
1Internal Medicine, Parkview Health, Fort Wayne, USA.
Cureus
|December 15, 2025
概括
抗中性细胞质抗体相关血管炎 (AAV) 很少会导致脚骨,需要截肢. 早期识别和治疗rituximab和prednisone可以改善这些复杂病例的结果.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 血管医学 血管医学
背景情况:
- 系统性血管性疾病包括各种影响血管的疾病.
- 抗中性细胞质抗体相关血管炎 (AAV) 通常会影响小至中型血管.
- AAV可以表现为各种各样的器官参与和临床表现.
研究的目的:
- 报告一种罕见的AAV病例,呈现出关键脚缺血和.
- 强调识别不寻常的AAV表现的重要性.
- 突出严重的AAV并发症的有效治疗策略.
主要方法:
- 一个74岁的女性患者的病例报告,患有并发症.
- 诊断工作包括自身免疫标记物 (反核抗体,周核ANCA).
- 对脚 necrosis 的临床评估,不包括神经和心血管病因.
主要成果:
- 尽管初始免疫抑制疗法 (普雷尼松,甲铁沙酸) 进行了治疗,但患者却出现了双边脚 necrosis.
- 排除外周缺血的其他常见原因.
- 在甲足截肢术后,Rituximab和Prednisone的成功管理.
结论:
- 虽然很少见,但AAV可能会出现严重的远端缺血和炎.
- 及时诊断和积极治疗对于预防AAV肢体损失至关重要.
- 这一案例强调了对非典型的AAV呈现需要保持警.
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