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副发性关节炎模仿晚期发病的风湿性关节炎在老年吸烟者:一个诊断挑战
Narayana Swamy1, Saraswathi Saiprasad2, David Garate3
1Rheumatology, Baylor Scott & White All Saints Medical Center - Fort Worth, Fort Worth, USA.
Cureus
|March 16, 2026
概括
副发性关节炎可以模仿类风湿性关节炎 (RA),延迟诊断. 这个案例展示了一名患有关节炎和肺部疾病的吸烟者,最终被诊断出患有肺癌和性关节炎.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
背景情况:
- 麻性类风湿综合征可以呈现为炎症性关节炎,模仿类风湿性关节炎 (RA).
- 当关节炎症状掩盖潜在的恶性瘤时,诊断延迟可能发生.
研究的目的:
- 为了突出一个模仿RA的副发性关节炎病例,在一个年长的男性吸烟者身上.
- 强调在患有新发炎性关节炎和肺部症状的患者中考虑隐性恶性瘤的重要性.
主要方法:
- 一个老年男性患有炎症性多关节炎和阳性类风湿因子 (RF) 的病例报告.
- 晚期发病的血清阳性RA的初始诊断,用葡萄糖皮质类药物和基.
- 由于持续的呼吸道症状,对胸部和活检进行HRCT的进一步评估.
主要成果:
- 这位患者出现多关节炎和低位射频,最初被诊断为RA.
- 关节炎随着治疗而改善,但呼吸道症状仍然存在.
- 人体肺癌检查发现纤维化间歇性肺病 (ILD) 和肺结节;活检证实非小细胞肺癌.
- 风湿病的诊断被修改为副发性关节炎.
结论:
- 在老年患者,特别是吸烟者的新发炎性关节炎,保证了对潜在恶性瘤的高度怀疑.
- 副发性关节炎可以潜伏地呈现,模仿常见的类风湿性疾病,如RA.
- 综合诊断方法,包括风湿病学,肺病学和瘤学,对于及时诊断和管理至关重要.
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