一个具有挑战性的多关节炎 (nodoza) 病例与关键四肢缺血症
Linn Renken1, Caroline Zollinger-Read1, Annabel Coote1
1Rheumatology, Doncaster Royal Infirmary, Doncaster, GBR.
Cureus
|December 22, 2025
概括
多关节炎 (PAN) 是一种罕见的血管炎. 本病例报告详细介绍了具有关键四肢缺血症,多器官心脏病发作和免疫抑制剂和抗凝剂成功治疗的侵袭性PAN表现.
科学领域:
- 类风湿病学 类风湿病学
- 血管医学 血管医学
- 案例报告 案例报告
背景情况:
- 多关节炎 (PAN) 是一种系统性血管炎,影响中小动脉.
- 关键四肢缺血是PAN的不常见但严重的并发症.
研究的目的:
- 报告一个具有广泛器官参与的侵略性系统性PAN病例.
- 突出诊断挑战和治疗策略的PAN呈现与关键四肢缺血.
主要方法:
- 一个64岁的男性病例报告,有宪法症状,皮肤病变和耳炎.
- 临床表现,包括血管造影和CT在内的诊断工作以及治疗过程被记录下来.
- 治疗包括高剂量的皮质类固醇,环胺,静脉免疫球蛋白和肝素.
主要成果:
- 患者患上了关键的右下肢缺血,需要截肢,以及多重单核炎和肌肉炎.
- 系统性参与包括脏,脏,心肌和关节梗塞以及关动脉封闭.
- 积极的免疫抑制和抗凝固药疗法导致C反应性蛋白水平显著降低.
结论:
- PAN可以呈现出严重的器官损伤,包括关键四肢缺血症.
- 及时诊断和多方面的治疗对于管理严重的PAN症状至关重要.
- 这一案例强调了在患有无法解释的全身炎症和血管事件的患者中考虑PAN的重要性.
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