以消化系统症状为主的系统性红斑狼疮一例误诊五年分析  

Systemic Lupus Erythematosus Characterized Mainly by Digestive System Symptoms:A Report of One Case Misdiagnosed for 5-years

作　　者：邱宇珍[1] 龙辉[2] 

机构地区：[1]武汉科技大学附属天佑医院风湿科,湖北省武汉市430064 [2]武汉科技大学附属天佑医院消化内科,湖北省武汉市430064

出　　处：《中国全科医学》2013年第13期1563-1565,共3页Chinese General Practice

摘　　要：本文报告了1例女性患者因反复腹泻、呕吐、浆膜腔积液等,2次抗痨治疗似乎有效,误诊结核性腹膜炎5年余,因再发上腹不适、恶心、呕吐3 d入院,经院内会诊诊断为:系统性红斑狼疮(SLE)合并肠系膜血管炎、假性肠梗阻、不全输尿管梗阻、狼疮肾炎。治疗后病情控制无反复。该病例提示:SLE以消化系统症状为首发表现者临床误诊率高,对于自身抗体阴性或低滴度阳性的患者合并多系统损害时要警惕SLE。A case of female patient with recurrent diarrhea, vomiting, serous cavity effusion, who 2 seemed to re- sponded to 2 - year treatment of anti - tuberculosis, had been misdiagnosed as tuberculous peritonitis for more than 5 years. Be- cause of recurrent upper abdominal discomfort, nausea, and vomiting for 3 days she was admitted, and a hospital - wide consul- tation confirmed her systemic lupus erythematosus （SLE） complicated by mesenteric vasculitis, intestinal pseudo - obstruction, incomplete ureteral obstruction, and lupus nephritis. Her disease was controlled after treatment, with no relapse. The case pro- motes that SLE with digestive symptoms as initial manifestations has a high rate of clinical misdiagnosis, so we must be alert to SLE when the patients have autoantibody - negative or low titer - positive with multi - system damage.

关 键 词：红斑狼疮 系统性 消化系统 误诊 

分 类 号：R593.24[医药卫生—内科学]