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当发烧首先出现时:慢性非细菌性骨髓炎的不寻常表现
Michaela Karam1, Eman Bamashmous2, Anand Gourishankar3
1SMHS, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA michaelakaram@gwmail.gwu.edu.
BMJ case reports
|December 15, 2025
概括
慢性非细菌性骨髓炎 (CNO) 可以在骨疼痛之前异常出现长期发烧. 在患有不明原因发烧的儿童中,早期考虑CNO对于及时诊断和治疗至关重要.
科学领域:
- 儿科 儿科 儿科
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 慢性非细菌性骨髓炎 (CNO) 是一种罕见的自身炎症性骨疾病.
- 它通常影响儿童和青少年,骨头疼痛是标志性症状.
- 由于逐渐发病和呈现变化的原因,诊断可能具有挑战性.
研究的目的:
- 为了突出CNO的非典型呈现.
- 强调在患有来源不明的长期发烧的儿童中考虑CNO的重要性.
主要方法:
- 一个青少年男性的案例报告.
- 临床表现包括长期发烧,,夜间出汗,头痛,体重减轻,后来间歇性骨痛.
- 诊断工作包括MRI和骨活检.
- 治疗包括非类固醇抗炎药物 (NSAIDs).
主要成果:
- 患者呈现出系统性症状 (发烧,体重减轻) 之前的骨疼痛.
- 核磁共振成像和骨活检支持了与CNO一致的自身炎症过程.
- 随着NSAIDs的使用,症状和炎症标志物得到改善.
结论:
- CNO可以不典型地表现为系统性症状,作为最初的投诉.
- 儿童长期发烧的来源不明,即使没有最初的骨疼痛,也需要考虑CNO.
- 早期诊断和使用NSAIDs的治疗可以导致症状改善.
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