系统性硬皮病合并横纹肌溶解1例  

A Case Report of Systemic Scleroderm a Associated with Rhabdomyolysis

作　　者：邹耘[1] 江文[1] 邓云华[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院皮肤科,湖北武汉430030

出　　处：《中国医学文摘（皮肤科学）》2017年第3期355-357,共3页China Medical Abstracts(Dermatology)

摘　　要：患者女,49岁。面部、双前臂皮肤发生肿胀与逐渐硬化1月余。入院时皮肤科情况:双前臂及面部皮肤肿胀,表面光滑,蜡样光泽,触之较硬且不易捏起。皮损组织病理检查符合硬皮病改变。入院后给予甲强龙注射液和活血化瘀等治疗的第10天,突发上腹部剧烈阵发性疼痛,全身大汗淋漓;经检查排除胸腹主动脉夹层、空腔脏器穿孔、心肌梗塞及胰腺炎。随后患者出现全身酸痛与肌力下降,实验室检查示肌酶谱进行性升高,尿呈酱油色。诊断为系统性硬皮病合并横纹肌溶解症。予大剂量糖皮质激素冲击及免疫抑制剂治疗,患者肌力改善,肌酶谱逐渐下降,病情渐好转出院。A 49-year-old female presented with swelled and hardened skin in her face and forearm for 1 months. Her medical examination at admission found that there was lots of edematous skin in her face and forearm and cutaneous wrinkles disappeared from these shiny and waxy lesions. The affected skin touched hard and not easy to be pinched. Histopathological examination of her skin lesions was checked to be consistent with scleroderma. She was prescribed with moderate dosages of intravenous methylprednisolone with activating blood circulation treatment. She suffered suddenly from severe abdominal pain with body sweating at the 10th day of treatment. Thoracoabdominal arterial dissection,perforation of visceral organs,myocardial infarction and pancreatitis were elimina-ted after a series of examination. The significant increase of serum creatine phosphokinase was discovered with her body ache and decreasing of muscles strength. The color of her urine looked like soy sauce. She was diagnosed as systemic scleroderma with rhabdomyolysis. High dose intravenous glucocorticoid pulse therapy was formulated for her with immunosuppressive agent. Her muscle strength was improved gradually with the muscle enzyme spectrum decreasing. Then she got better and discharged from hospital.

关 键 词：系统性硬皮病 横纹肌溶解 

分 类 号：R593.25[医药卫生—内科学] R685.5[医药卫生—临床医学]