强直性脊柱炎伴门脉高压及地衣淀粉样变1例

M. Çoban, C. Kaya, A. Cevik, H. Değertekin
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摘要

本文报告一个强直性脊柱炎(AS)患者随访40年,并逐渐发展为糖尿病、虹膜睫状体炎、地衣淀粉样变和高血压的病例。患者男73岁,近一年来以呼吸困难、大量腹水合并门静脉高压症就诊。心脏和肝静脉压测量显示轻度心包增厚和肝内肝窦门静脉高压。未发现代谢性、病毒性、自身免疫性等浸润性原因导致门静脉高压症的发生,认为as可引起全身性炎症和血管受累。由于顽固性腹水,对患者应用TIPS。术后不需要白蛋白,胃酸消退,全身情况好转。我们旨在介绍罕见的AS,地衣淀粉样变和门静脉高压症的联系,以及TIPS手术的疗效。
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An Ankylosing Spondylitis Case Which Accompanies Portal Hypertension and Lichen Amyloidosis
ABS TRACT In this paper, we present a case that has been followed with Ankylosing Spondylitis (AS) for forty years and developed diabetes, iridocyclitis, lichen amyloidosis and hypertension over time. A 73-year-old male patient presented to our hospital with dyspnea and massive ascites with portal hypertension in the last one year. Cardiac and hepatic venous pressure measurements revealed mild pericardial thickening and intrahepatic sinusoidal portal hypertension in the liver. An infiltrative reason as metabolic, viral, autoimmune to develop portal hypertension was not found and systemic inflammation and vascular involvement due to AS was thought. TIPS was applied to the patient due to resistant ascites. After this operation, albumin was not needed, acid regressed and general condition improved. We aimed to present a very rarely seen association of AS, lichen amyloidosis and portal hypertension, and the curative result of TIPS operation in this case.
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