系统性红斑狼疮、多发性肌炎和系统性硬皮病重叠综合征1例  

A Case of Overlap Syndrome with Systemic Lupus Erythematosus,Polymyositis and Systemic Scleroderma

作　　者：卢井发[1] 叶小英[1] 万春雷[1] 黄东北[1] 尤聪[1] 林儒斌[1] 郑威[1] 曾招林[1] 

机构地区：[1]赣南医学院第一附属医院皮肤科,江西赣州341000

出　　处：《中国皮肤性病学杂志》2015年第9期941-942,977,共3页The Chinese Journal of Dermatovenereology

摘　　要：患者男,36岁。前额、面部皮肤红斑伴瘙痒1年余,四肢乏力4月余。1年前前额、面部出现红斑、脱屑,伴有瘙痒;8个月后出现站立困难,自觉无力,双手手指肿胀呈紫红色,在当地检查示肌酶升高;1个月前口腔黏膜出现溃疡,持续不愈,右侧腕关节、双侧膝关节相继出现疼痛,胸前、前额皮肤变硬、发亮有光泽。实验室检查:ALT 78U/L,AST 200U/L,LDH 601U/L,CK 5 472U/L,CK-MB 127U/L;SSA(+),Ro-52(+),ANA 1∶320(+)。胸部CT示间质性肺炎;肌电图示肌源性损害,紫外线光敏检查阳性。诊断为系统性红斑狼疮、多发性肌炎和硬皮病重叠综合征。A 36-year-old male presented with erythema and crusting of the forehead and face for over a year with limb weakness persisting for over four months. Erythema and desquamation were found on the forehead and face accompanied by itching. Eight months later the patient had difficulty in standing up with generalized weakness and purple swelling on the fingers of both hands. The levels of creatase was found higher than the normal ones in the local hospital. One month ago persistent ulcers were found in the oral cavity following by pain on the right wrist and both knee joints. Then the skin on the chest and forehead turned sclerous and shiny. The laboratory test results in our hospital were as follows ： ALT： 78 U/L, AST： 200U/L, LDH ： 601 U/L, CK： 5 472 U/L, CK-MB ： 127U/L; SSA positive, Ro-52 positive, ANA ： 1 ： 320 positive. Chest CT scans revealed interstitial pneumonia, and electromyogram showed myogenic damage and the resuhsof UV photosensitivity test is positive. The diagnosis was overlap syndrome （OS） with systemic lupus erythematosus （SLE）, polymyositis （PM） , and systemic scleroderma （SSc）.

关 键 词：重叠综合征 系统性红斑狼疮 多发性肌炎 系统性硬皮病. 

分 类 号：R593.2[医药卫生—内科学]