Lupus-related protein-losing enteropathy associated with pseudo-pseudo Meigs' syndrome and successfully treated with hydroxychloroquine.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI:10.2478/rjim-2021-0032
Taro Horino, Masami Ogasawara, Takeshi Kashio, Satoshi Inotani, Masayuki Ishihara, Hiroshi Ohnishi, Masahiro Komori, Osamu Ichii, Yoshio Terada
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引用次数: 3

Abstract

We herein report the first case of lupus-related protein-losing enteropathy associated with pseudo-pseudo Meigs' syndrome. Lupus-related protein-losing enteropathy and pseudo-pseudo Meigs' syndrome are extremely rare complications in patients with systemic lupus erythematosus, Both have a similar clinical course characterized by producing marked ascites, and respond to steroids in typical cases. However, in our case, steroid monotherapy was inadequate and the addition of hydroxychloroquine was effective for their treatment. Furthermore, no reports have previously confirmed elevated CA 125 levels with lupus-related protein-losing enteropathy or increased 99mTc-HSA activity with pseudo-pseudo Meigs' syndrome. In addition, we are the first to report an evaluation of the histopathology of lupus-related protein-losing enteropathy. Previously reported cases have been described as being caused by either pseudo-Meigs's syndrome or lupus-related protein-losing enteropathy as the cause of the rare pathology that causes marked pleural effusion and ascites in patients with systemic lupus erythematosus, but it has not been evaluated whether the other is co-occurring. Our case highlights that there is a potential case of overlapping lupus-related protein-losing enteropathy and pseudo-Pseudo-Meigs's syndrome. Furthermore, it is possible that patients with marked ascites with elevated CA 125 levels were mistakenly diagnosed with Meigs's syndrome or pseudo-Meigs's syndrome associated with malignant or benign ovarian tumors and underwent surgery. Clinicians should not forget SLE with pseudo-Pseudo-Meigs's syndrome as one of the differential diagnoses for marked ascites with elevated CA 125 levels.

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狼疮相关蛋白丢失性肠病伴伪伪Meigs综合征,羟氯喹成功治疗。
我们在此报告第一例狼疮相关蛋白丢失性肠病合并伪伪Meigs综合征。狼疮相关蛋白丢失性肠病和伪伪Meigs综合征是系统性红斑狼疮患者极为罕见的并发症,两者具有相似的临床病程,其特征是产生明显的腹水,典型病例对类固醇有反应。然而,在我们的病例中,类固醇单药治疗是不够的,羟氯喹的加入对治疗是有效的。此外,以前没有报告证实狼疮相关蛋白丢失性肠病患者CA 125水平升高或伪伪Meigs综合征患者99mTc-HSA活性升高。此外,我们是第一个报告评估狼疮相关蛋白丢失性肠病的组织病理学。以前报道的病例被描述为由伪meigs综合征或狼疮相关蛋白丢失性肠病引起的,这是引起系统性红斑狼疮患者明显胸腔积液和腹水的罕见病理,但尚未评估其他是否共同发生。我们的病例强调,有重叠狼疮相关的蛋白质丢失性肠病和伪伪meigs综合征的潜在病例。此外,CA 125水平升高的明显腹水患者可能被误诊为恶性或良性卵巢肿瘤相关的Meigs综合征或伪Meigs综合征,并接受了手术。临床医生不应忘记SLE合并伪伪meigs综合征作为CA 125水平升高的明显腹水的鉴别诊断之一。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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