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局部免疫复杂小血管血管炎呈现为单边肌肉炎在甲型肝炎后

Mariam Zeidan¹, Rita Abou Zeid², Hajar Alhusani²

¹Faculty of Medicine, American University of Beirut, Beirut, LBN.

|January 7, 2026

概括

本案例研究详细介绍了第一例单边免疫复杂小血管血管炎 (ICSVV) 影响腿部肌肉,由甲型肝炎病毒 (HAV) 感染引发. 及时的免疫抑制治疗导致缓解,突出早期诊断的重要性.

科学领域:

风湿病学和免疫学
传染性疾病传染性疾病
血管医学血管医学

背景情况:

免疫复杂小血管血管炎 (ICSVV) 涉及免疫复杂沉积在小血管中,导致炎症和亡.
甲型肝炎病毒 (HAV) 是一种不常见的血管炎触发因素,与乙型肝炎和C型肝炎不同.
血管性肌肉炎,由于血管炎引起的肌肉炎症,通常是双边和对称的,很少有单边或肌肉受限疾病的报道.

研究的目的:

报告第一个经过活检证明的单边免疫复杂血管肌炎与急性甲型肝炎病毒感染相关的病例.
强调焦点四肢胀与全身炎症的诊断考虑,即使具有正常的肌酸酶水平.
突出MRI导向活检在诊断血管性肌肉炎中的实用性.

主要方法:

一份病例报告显示,一名30多岁的女性在HAV感染后出现单侧大腿胀和全身炎症.
诊断工作包括实验室测试 (WBC,CRP,ESR,CK),轴向FDG-PET/CT和冠状MRI.
用MRI指导的大侧肌肉活检进行,以确认诊断.

主要成果:

患者呈现严重的全身炎症 (WBC 30×103/μL,CRP 348 mg/L,ESR>100 mm/h) 和正常的肌酸激酶.
图像检测显示左大腿的扩散性炎症;活检证实了肌内动脉的转移性炎症和纤维状缩,与ICSVV一致.
用普得尼松和甲状腺治疗导致CRP在四周内显著下降,并在六个月内缓解.

结论:

这一案例确立了活检证明的单边免疫复杂血管肌炎和HAV感染之间的第一个联系.
它强调了在对焦点四肢胀与全身炎症的差异诊断中考虑血管性肌肉炎的重要性.
早期的免疫抑制疗法对于这种罕见疾病的良好结果至关重要.

关键词:

案例报告案例报告甲型肝炎是一种肝炎.免疫复杂的血管炎.通过MRI指导的活检.肌肉性肌肉性炎症肌肉性肌肉炎小血管血管炎的血管炎.系统性炎症系统性炎症一边的四肢胀血管性肌肉炎是一种神经炎症.

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