在治疗系统性红斑狼期间,出现与蛋白质损失肠病相关的扩散型大B细胞淋巴瘤病例
Shintaro Yasui1, Keisuke Nishimura1, Yukina Tanimoto1
1Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan.
Internal medicine (Tokyo, Japan)
|January 14, 2026
概括
失去蛋白质的肠道病变 (PLE),一种罕见的全身性红斑狼 (SLE) 并发症,被患者的扩散大B细胞淋巴瘤模仿. 这一案例凸显了在与SLE相关的耐治疗PLE中考虑淋巴瘤的重要性.
科学领域:
- 胃肠病学 胃肠病学
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
背景情况:
- 失去蛋白质的肠病变 (PLE) 是系统性红斑狼 (SLE) 的罕见但严重的并发症.
- 患有SLE相关PLE的患者往往呈现低albuminemia,和贫血,这可能是具有挑战性的管理.
- 在PLE中抗治疗性可能表明另一个潜在的病理.
研究的目的:
- 报告一种独特的扩散性大B细胞淋巴瘤 (DLBCL) 病例,该病例在患有SLE的患者中呈现为PLE.
- 强调DLBCL模仿SLE患者PLE所带来的诊断挑战.
- 强调在耐火性SLE相关PLE病例中需要考虑DLBCL的必要性.
主要方法:
- 一个38岁女性的案例研究,她患有良好的SLE.
- 诊断评估包括评估腹部疼痛,,贫血和低albuminemia.
- 对小肠病变进行了双气球肠镜检查和活检,以确认诊断.
主要成果:
- 这位患者最初被诊断为PLE,尽管接受了葡萄糖皮质类药物和环胺的治疗,但患有持续的低albuminemia.
- 通过双气球肠镜检查的活检揭示了扩散性大B细胞淋巴瘤 (DLBCL).
- 这是首次报告DLBCL在SLE的背景下模仿PLE的情况.
结论:
- 恶性淋巴瘤,特别是DLBCL,应在与SLE相关的耐治疗PLE的差异诊断中考虑.
- 早期识别和适当的瘤管理对于SLE患者呈现耐火PLE的患者至关重要.
- 这一案例强调了在症状持续存在时,除了典型的PLE管理之外进行彻底调查的重要性.
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