以颈部淋巴结病为表现的系统性红斑狼疮1例

Hyun-Seok Kang, J. Park, Tae Hwan Kim, Sang Hyuk Lee
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摘要

系统性红斑狼疮(SLE)是一种多系统自身免疫性疾病。SLE常见于年轻女性,早期症状包括发热、肌痛、关节痛、体重减轻、淋巴结病,这些非特异性症状可发展为皮疹、脾肿大、浆液炎和脑病。SLE的诊断需要临床和血清学标准,治疗选择为轻度疾病时使用羟基喹诺酮类药物和非甾体抗炎药,重度疾病时使用皮质类固醇和免疫抑制剂。在狼疮患者中,淋巴结病的患病率为12~59%。虽然淋巴病变在SLE中很常见,但在SLE早期很难区分。一名38岁妇女因颈淋巴肿大合并多发性关节炎及全身不适来我院就诊。颈部CT示多发颈部淋巴结肿大,血清学实验室检测ANA、抗磷脂抗体、抗dsdna阳性。排除淋巴瘤,行PET-CT及切除活检。患者最终确诊为SLE,并定期随访,无并发症。
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A Case of Systemic Lupus Erythematosus Presenting as Cervical Lymphadenopathy
Systemic lupus erythematosus(SLE) is a multisystemic disorder of autoimmune etiology. SLE can occur commonly in young women, and the early symptoms include fever, myalgia, arthralgia, weight loss, lymphadenopathy and these nonspecific symptoms develop into skin rash, splenomegaly, serositis and encephalopathy. Diagnosis of SLE requires clinical and serologic criteria, and treatment choices are hydroxyquinolone and NSAIDs for mild disease, corticosteroids and immunosuppressant for severe disease.In lupus patient, the prevalence of lymphadenopathy is 12~59%. Although lymphadenopathy is common finding in SLE, it is hard to distinguish in early phase of SLE.A 38-year-old woman visited our hospital for cervical lymphadenopathy with polyarthritis and malaise. Multiple cervical lymph nodes enlargement was found on Neck CT, and serologic laboratory test including ANA, antiphospholipid antibody, and anti-dsDNA was positive. For excluding lymphoma, PET-CT and excisional biopsy were performed. The patient finally diagnosed with SLE, and got regular follow-up without complication.
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