多关节炎与腹痛作为主要症状:一个病例报告
1Department of Gastroenterology, Guankou Township Center Hospital, Fujian, China.
Medicine
|December 16, 2025
概括
结节性多关节炎 (PAN) 的诊断具有挑战性,往往导致治疗延迟和不良结果. 本案例报告详细介绍了成功诊断和治疗PAN的情况,强调早期识别可以改善存活率.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 多关节炎 (PAN) 是一种罕见的全身性瘤性血管炎,具有诊断挑战.
- 延迟诊断PAN是常见的,并与严重的不良结果相关,包括死亡.
- 早期识别和治疗PAN对于改善患者存活率至关重要.
研究的目的:
- 介绍一个多肠炎结节 (PAN) 的病例报告,以突出诊断挑战.
- 强调包括PAN在无法解释症状的患者的差异诊断中的重要性.
- 提供有关PAN的识别和管理的见解.
主要方法:
- 一名65岁的女性患者出现了无法解释的腹痛.
- 诊断工作包括实验室检测 (低白血症,D-二次数升高,免疫球蛋白降低,阳性ANA),神经导电肌图和CT血管图.
- 根据临床发现 (体重减轻,腿部疼痛,多神经病变) 和动脉检查结果确认了PAN的诊断.
主要成果:
- 患者接受了高剂量的皮质类固醇 (甲基普雷迪诺,普雷迪诺) 和环胺的治疗,随后接受了甲状腺素治疗以维持缓解.
- 患者实现了缓解,并维持了免疫抑制治疗2年.
- 在停止治疗两年后,该患者仍然无症状,没有PAN复发的迹象.
结论:
- 这一案例强调了与多肠炎 (PAN) 相关的诊断复杂性.
- 在PAN患者中维持长期缓解需要仔细管理和监测.
- 胃肠科医生和其他临床医生必须在相关的临床场景中保持对PAN的高度怀疑指数.
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