成人Still病伴胸腔积液诊治分析  

Diagnosis and Treatment Analysis of Adult Onset Still's Disease Combined with Pleural Effusion

作　　者：李雪英[1] 胡苏萍[1] 聂汉祥[1] 杨珍[1] 

机构地区：[1]武汉大学人民医院呼吸内科,武汉430060

出　　处：《临床误诊误治》2013年第2期15-18,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨成人Still病的诊断和鉴别诊断。方法回顾性分析以肺部改变为特征误诊为肺炎并肺炎旁积液的成人Still病2例的临床资料。结果 2例均因发热、咳嗽、胸痛入院,行胸部高分辨率CT示双下肺斑片状密度增高影并双侧胸腔积液,误诊为肺炎并肺炎旁积液,抗菌药物治疗无效,结合其他检查考虑成人Still病,给予糖皮质激素治疗后治愈。结论成人Still病缺乏特异性临床表现,难以与其他感染性及非感染性疾病相鉴别,当病变侵犯肺脏时易误诊为肺炎,因此当肺部受累时需考虑成人Still病可能。Objective To explore the differential diagnosis of adult onset Still disease （AOSD）. Methods Clinical data of 2 patients with AOSD who had bellows changes and were misdiagnosed as having pneumonia combined with pleural effusion were retrospectively analyzed. Results The 2 patients were admitted for fever, cough and chest pain, and chest high resolution CT scans showed double low lobe pneumal patching dense shadow infiltration with bilateral pleural effusion, and the 2 patients were misdiag- nosed as having pneumonia combined with pleural effusion. Antimicrobial treatment was unresponsive, but glucocorticosteroid treat- ment had good curative effect for AOSD combined with other examinations. Conclusion AOSD lacks in characterized features, which is difficult to be differentiated from other infectious and noninfectious diseases. When pulmonary infiltration occurs, AOSD can be easily misdiagnosed as pneumonia. So AOSD should be considered when pulmonary infiltration happens.

关 键 词：成人STILL病 误诊 胸腔积液 肺炎 

分 类 号：R593.2[医药卫生—内科学]