Case Reports in Rheumatology最新文献

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Tophaceous Gout in the Pancreas: Case Reports and Review of the Literature 胰腺的痛风:病例报告和文献回顾

Case Reports in Rheumatology

Pub Date : 2022-06-03 DOI: 10.1155/2022/3671627

Sooji Choi, N. Voskanian, Jeffrey Ramos, Katherine Nguyen

We report 3 patients who presented with abnormal pancreatic contents that were initially nondiagnostic but were eventually found to have urate crystal deposition consistent with pancreatic tophaceous gout. Our first case involved an ICU patient who had fever of unknown origin and refractory pancreatic pseudocyst. The other 2 patients presented with abdominal pain associated with a pancreatic mass which mimicked malignancy. After further investigation, we were able to identify pancreatic tophaceous gout as the diagnosis. Initiation of therapy led to resolution of pancreatitis in the first patient and resolution of abdominal pain and decrease in size of a pancreatic mass in the other 2 patients. The recognition of clinical gout involving the pancreas has important implications in the evaluation and care of these patients who are at high risk for tophaceous gout. In addition, the importance of specimen preparation that preserves crystals for viewing is discussed.

我们报告了3例胰腺内容物异常的患者，最初无法诊断，但最终发现尿酸结晶沉积与胰痛风一致。我们的第一个病例涉及一位ICU患者，他有不明原因的发烧和难治性胰腺假性囊肿。另外2例患者表现为腹痛并伴有胰腺肿块，类似恶性肿瘤。经过进一步的调查，我们能够确定胰腺痛风作为诊断。开始治疗后，第1例患者的胰腺炎得到缓解，另外2例患者的腹痛得到缓解，胰腺肿块变小。认识到临床痛风涉及胰腺有重要意义的评估和护理这些患者谁是风疹痛风的高风险。此外，还讨论了保存晶体以供观察的标本制备的重要性。

引用次数: 3

A Case Report of Statin-Induced Immune-Mediated Necrotizing Myopathy Treatment Challenges 他汀类药物诱导的免疫介导的坏死性肌病治疗挑战1例报告

Case Reports in Rheumatology

Pub Date : 2022-05-31 DOI: 10.1155/2022/4647227

Anwar I. Joudeh, M. K. Albuni, S. Hassen, Phool Iqbal, Elsaid M Aziz Bedair, Salah Mahdi

Statin-induced necrotizing autoimmune myopathy is an immune-mediated necrotizing myopathy related to the use of statins. It is a very rare disease, which usually presents with proximal muscle weakness and frank elevation in creatine kinase levels. Stopping statin and the use of immunosuppressive therapy are considered the mainstay therapy. Use of steroids in patients with inflammatory myopathy can be complicated by steroid-induced myopathy. Herein, we present a case of a 55-year-old patient with statin-induced necrotizing autoimmune myopathy based on the presence of proximal muscle weakness, magnetic resonance findings, suggestive muscle biopsy features, and positive anti-HMGCR autoantibodies. The patient was treated with triple immunosuppressive therapy with a particularly good response to intravenous immunoglobulin. This report highlights the importance of timely diagnosis and early use of combined immunosuppressive therapy to improve patients' outcome affected by this rare disease.

他汀类药物诱导的坏死性自身免疫性肌病是一种与他汀类药物使用有关的免疫介导的坏死性肌病。这是一种非常罕见的疾病，通常表现为近端肌肉无力和肌酸激酶水平明显升高。停止他汀类药物和使用免疫抑制疗法被认为是主要的治疗方法。炎性肌病患者使用类固醇可并发类固醇诱发的肌病。在此，我们报告了一例55岁的他汀类药物诱导的坏死性自身免疫性肌病，基于近端肌肉无力的存在，磁共振结果，暗示的肌肉活检特征，以及抗hmgcr自身抗体阳性。患者接受三联免疫抑制治疗，静脉注射免疫球蛋白反应特别好。本报告强调了及时诊断和早期使用联合免疫抑制治疗以改善这种罕见疾病影响患者预后的重要性。

引用次数: 4

Three's Company: Coexistence of Silicosis, Scleroderma, and Sjogren Syndrome in a Single Patient 三人行:矽肺、硬皮病和干燥综合征在同一患者中的共存

Case Reports in Rheumatology

Pub Date : 2022-05-27 DOI: 10.1155/2022/4487638

Alexis Ziebelman, Shir Raibman-Spector, O. Gendelman

We describe a patient who presented with silicosis, scleroderma, and Sjogren syndrome all at the same time. The diagnoses in this case are all associated with continuous exposure to crystalline silica at the patient's workplace. The following report discusses this unique presentation.

我们描述了一个病人谁提出矽肺，硬皮病，干燥综合征所有在同一时间。本病例的诊断均与患者工作场所持续接触结晶二氧化硅有关。下面的报告将讨论这种独特的表示。

引用次数: 1

Myocardial Infarction in a 7-Year-Old Girl with Polyarteritis Nodosa 7岁女童结节性多动脉炎心肌梗死1例

Case Reports in Rheumatology

Pub Date : 2022-04-26 DOI: 10.1155/2022/2175676

Lina Bayazeed, Alaa Felimban, Abdulsalam Alsaiad, Fahd Alsufiani, J. Alqanatish

Polyarteritis nodosa (PAN) is a rare systemic vasculitis that affects small to medium-sized arteries. It could affect any organ including the heart. However coronary artery involvements are very rare. We describe a young girl who presented following a histopathological diagnosis of PAN with acute chest pain, high serum troponin, and progressive ischemic changes in the electrocardiogram (ECG). Induction of remission of her disease was done with six-moths Cyclophosphamide infusions and pulse corticosteroids. In addition to anticoagulation and dual antithrombotic therapy, the disease remission was maintained with mycophenolate mofetil which helps in the recovery of coronary disease. Our case illustrates the serious cardiac involvement of PAN in a child that responded to intensive management.

结节性多动脉炎(PAN)是一种罕见的影响中小动脉的全身性血管炎。它可以影响包括心脏在内的任何器官。然而，累及冠状动脉是非常罕见的。我们描述了一个年轻的女孩，她在组织病理学诊断后出现急性胸痛，血清肌钙蛋白升高，心电图(ECG)进行性缺血改变。通过6个月环磷酰胺输注和脉冲皮质类固醇诱导其疾病缓解。除了抗凝和双重抗血栓治疗外，使用霉酚酸酯维持疾病缓解，这有助于冠心病的恢复。我们的病例说明了严重的PAN患儿心脏受累，对强化治疗有反应。

引用次数: 0

Enthesitis in Bowel-Associated Dermatosis-Arthritis Syndrome in an Ulcerative Colitis Patient 溃疡性结肠炎患者肠道相关皮肤病-关节炎综合征并发肠炎

Case Reports in Rheumatology

Pub Date : 2022-04-12 DOI: 10.1155/2022/4556250

Khalid S Alshahrani, A. Almohaya, Rayan S. Hussein, R. H. Ali

Bowel-associated dermatosis-arthritis syndrome (BADAS) is a rare and recurrent neutrophilic dermatosis condition. Due to the rarity of this syndrome and the difficulty of the disease recognition and management, there was no clear reported incidence rate of this syndrome. 20% of patients after ileojejunal bypass surgery for morbid obesity were reported, by Jorizzo et al., to have BADAS. The underlying etiology of BADAS is not fully understood; therefore, the diagnosis of this condition is difficult and the approach for the management as well. Herein, we report a case of BADAS with unusual musculoskeletal presentation.

肠相关性皮肤病-关节炎综合征(BADAS)是一种罕见的复发性中性粒细胞皮肤病。由于本病罕见，该病不易识别和治疗，目前尚无明确的发病率报道。据Jorizzo等人报道，20%因病态肥胖而接受回肠空肠搭桥手术的患者出现BADAS。BADAS的潜在病因尚不完全清楚;因此，这种疾病的诊断和治疗方法都很困难。在此，我们报告一例具有不寻常的肌肉骨骼表现的BADAS。

引用次数: 2

A Case of Rapidly Progressing Hepatocellular Carcinoma after Administration of JAK Inhibitors to Treat Rheumatoid Arthritis JAK抑制剂治疗类风湿关节炎后快速进展的肝细胞癌一例

Case Reports in Rheumatology

Pub Date : 2022-03-29 DOI: 10.1155/2022/6852189

Rioko Migita, Y. Kimoto, Junki Hiura, Yuta Okumura, T. Horiuchi

We report a case of rapidly progressing hepatocellular carcinoma after administration of Janus kinase (JAK) inhibitors to treat rheumatoid arthritis. A 76-year-old man was referred to our Department for pain in multiple joints and was diagnosed with rheumatoid arthritis. Blood tests revealed elevated hepatobiliary enzymes, but various tests revealed no signs suggestive of malignancy. He took baricitinib for 2 months followed by tofacitinib for 4 months. After that, he was diagnosed with hepatocellular carcinoma based on imaging findings and elevated tumor markers. This case showed the possibility of a causal relationship between JAK inhibitors and malignancy.

我们报告一例快速进展的肝细胞癌后给予Janus激酶(JAK)抑制剂治疗类风湿关节炎。一名76岁男性因多关节疼痛就诊于我科，诊断为类风湿关节炎。血液检查显示肝胆酶升高，但各种检查均未发现恶性肿瘤迹象。服用巴氏替尼2个月，托法替尼4个月。在那之后，他被诊断为肝细胞癌基于影像学发现和肿瘤标志物升高。这个病例显示了JAK抑制剂和恶性肿瘤之间可能存在因果关系。

引用次数: 0

Hodgkin Lymphoma Mimicking Lumbar Spine Tuberculosis 模拟腰椎结核的霍奇金淋巴瘤

Case Reports in Rheumatology

Pub Date : 2022-02-25 DOI: 10.1155/2022/5298960

H. J. Djossou, M. A. Ghassem, H. Toufik, M. Oukabli, A. Bezza, L. Achemlal

Introduction The clinical manifestations of Hodgkin lymphoma (HL) can closely mimic spine and lymph node tuberculosis (TB). Case Description. A 48-year-old man was initially treated for retroperitoneal lymph nodes TB, and this diagnosis was made without bacteriological and histopathological confirmation. After four months of regular therapy for TB, he did not improve and was admitted to our department for lumbar spine pain. We first made diagnosis of tuberculous spondylodiscitis, and anti-TB treatment was strengthened. But, after three weeks of hospitalization, his condition worsened clinically with onset of swelling of the left supraclavicular lymph node. So, after surgical excision and anatomopathological examination of the lymph node, the diagnosis of nodular sclerosis classic Hodgkin lymphoma was made. He was treated by chemotherapy, and his condition improved significantly after the first 2 cycles of chemotherapy. Conclusion Repeated investigations may be helpful in establishing a correct diagnosis and starting an effective treatment in this highly curable disease.

霍奇金淋巴瘤(HL)的临床表现与脊柱和淋巴结结核(TB)非常相似。案例描述。一名48岁男子最初因腹膜后淋巴结结核接受治疗，该诊断在没有细菌学和组织病理学证实的情况下做出。经过4个月的结核病常规治疗，患者病情没有好转，因腰椎疼痛住进我科。我们首先诊断为结核性脊柱炎，并加强抗结核治疗。但是，在住院三周后，他的病情在临床上恶化，开始出现左侧锁骨上淋巴结肿胀。经手术切除及淋巴结解剖病理检查，诊断为结节硬化型霍奇金淋巴瘤。患者接受化疗治疗，前2个周期化疗后病情明显好转。结论反复检查有助于该病的正确诊断和有效治疗。

引用次数: 2

Erratum to “A Rare Case of Fatal Hemorrhagic Stroke in a Young Female with Early Mixed Connective Tissue Disease” “1例年轻女性早期混合性结缔组织病致死性出血性中风”的勘误

Case Reports in Rheumatology

Pub Date : 2022-02-23 DOI: 10.1155/2022/9762151

James R. Agapoff IV

[This corrects the article DOI: 10.1155/2021/5321438.].

[这更正了文章DOI: 10.1155/2021/5321438.]

引用次数: 0

Chemosis as an Initial Presentation of Systemic Lupus Erythematosus. 化脓是系统性红斑狼疮的初始表现。

Case Reports in Rheumatology

Pub Date : 2022-02-15 eCollection Date: 2022-01-01 DOI: 10.1155/2022/4912092

Carvy Floyd Luceno, Minho Yu, Daniel I Kim, Vaneet K Sandhu

Systemic lupus erythematosus (SLE) can present in a multitude of ways, which can be confounding and misleading for a clinician. Chemosis as an initial presentation is rare and has only been documented on a few case reports. However, when present, simultaneous involvement of other organs is likely. We present a previously healthy 29-year-old male who presented with severe bilateral chemosis and was subsequently diagnosed with SLE and antiphospholipid syndrome. Complications included multiple acute cerebral infarcts, lupus psychosis, lupus pleuritis, and lupus nephritis. The patient recovered well with appropriate treatment and chemosis ultimately resolved. Recognizing chemosis as an initial presentation of SLE is vital for appropriate evaluation and timely treatment to prevent disease progression.

系统性红斑狼疮(SLE)可以以多种方式出现，这对临床医生来说可能是混淆和误导的。化疗作为最初的表现是罕见的，只有记录在少数病例报告。然而，当出现时，可能同时累及其他器官。我们报告了一位先前健康的29岁男性，他表现为严重的双侧化脓，随后被诊断为SLE和抗磷脂综合征。并发症包括多发性急性脑梗死、狼疮性精神病、狼疮性胸膜炎和狼疮性肾炎。经适当治疗，患者恢复良好，化脓症最终消失。认识到化脓是SLE的初始表现，对于适当评估和及时治疗以预防疾病进展至关重要。

引用次数: 0

New-Onset Systemic Lupus Erythematosus after mRNA SARS-CoV-2 Vaccination. mRNA SARS-CoV-2疫苗接种后新发系统性红斑狼疮。

Case Reports in Rheumatology

Pub Date : 2022-02-11 eCollection Date: 2022-01-01 DOI: 10.1155/2022/6436839

Laisha Báez-Negrón, Luis M Vilá

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease resulting from the interaction of genetic and environmental factors. In addition, some antiviral vaccines have been associated with the onset of SLE. Few cases of SLE occurring after SARS-CoV-2 mRNA have been reported. Herein, we report the case of a 27-year-old woman with type I diabetes mellitus and family history of SLE who presented with symmetric inflammatory polyarthritis of the proximal interphalangeal joints, metacarpophalangeal joints, wrists, knees, and ankles two weeks after receiving the second dose of the SARS-CoV-2 mRNA-1273 vaccine. Laboratory results revealed positive antinuclear, anti-dsDNA, anti-Ro, and anti-La/SSB antibodies and low C4 levels. She was initially treated with low-dose prednisone and hydroxychloroquine. Hydroxychloroquine was discontinued after she developed an urticarial rash. Subsequently, mycophenolate mofetil was added after she developed proteinuria. This case highlights the importance of considering the diagnosis of SLE in patients who present with inflammatory polyarthritis after COVID-19 vaccination.

系统性红斑狼疮(SLE)是一种遗传和环境因素共同作用下的多系统自身免疫性疾病。此外，一些抗病毒疫苗与SLE的发病有关。SARS-CoV-2 mRNA表达后发生SLE的病例报道较少。在这里，我们报告了一名27岁的女性，患有1型糖尿病和SLE家族史，在接受第二剂SARS-CoV-2 mRNA-1273疫苗两周后，她出现了近端指间关节、掌指关节、手腕、膝盖和脚踝的对称炎性多关节炎。实验室结果显示抗核、抗dsdna、抗ro和抗la /SSB抗体阳性，C4水平低。她最初接受小剂量强的松和羟氯喹治疗。在她出现荨麻疹后停用羟氯喹。随后在患者出现蛋白尿后加入霉酚酸酯。该病例强调了在COVID-19疫苗接种后出现炎性多关节炎的患者考虑SLE诊断的重要性。

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引用次数: 18

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