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一个AL粉样粉症相关关节炎病例最初被误诊为类风湿性关节炎
Yukina Tanimoto1, Hirotaka Yamada1, Shintaro Yasui1
1Department of Rheumatology and Clinical Immunology, Kobe University Hospital, Kobe, Japan.
Modern rheumatology case reports
|March 5, 2026
概括
粉样蛋白轻链 (AL) 粉样蛋白可以导致模仿类风湿性关节炎 (RA) 的关节炎. 这一案例突出了在异常性关节炎中考虑AL粉样化症,肌肉骨超声波 (MSKUS) 帮助诊断.
科学领域:
- 类风湿病学 类风湿病学
- 血液学 血液学 血液学
- 放射学 放射学是一门学科.
背景情况:
- 粉样蛋白轻链 (AL) 粉样蛋白,由于过多的免疫球蛋白轻链,在约3.7%的病例中影响关节.
- 骨髓瘤相关的粉样性关节病 (MAA) 通常模仿类风湿性关节炎 (RA),使诊断复杂化.
- 与AL氨基粉症相关的关节炎的特定超声波特征尚不清楚.
研究的目的:
- 要呈现一个AL粉样性粉症相关关节炎的病例,错误诊断为血清阴性RA.
- 强调在MAA中成像的诊断挑战和作用.
- 强调在耐火性或非典型关节炎中考虑AL粉样化症的重要性.
主要方法:
- 病例报告详细说明了诊断工作.
- 包括肌肉骨超声波 (MSKUS),MRI,超声波导向活检.
- 系统性评估:血清/尿蛋白电泳,骨髓检查.
主要成果:
- 在最初的错误诊断后,被诊断为血清阴性RA.
- MSKUS揭示了非典型的突变化,有助于指导活检.
- 观察到正功率多普勒信号,扩大已知的超声波频谱.
结论:
- 在非典型或血清消极性关节炎的差异诊断中应考虑AL粉症,特别是在治疗反应差或全身症状的情况下.
- MSKUS可以建议粉样蛋白沉积,并指导活检以确定诊断.
- 观察到的超声波发现扩大了对粉样性关节病的表现的理解.
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