老年自身免疫性多腺体综合征ⅢB+C型  

Clinical case discussion: Autoimmune polyglandular syndrome type Ⅲ B+C in the elderly

作　　者：李瑞华 江文静[1] 张楠[1] 林岩 叶翔[1] 麻琳[1] 单培彦[1] Li Ruihua;Jiang Wenjing;Zhang Nan;Lin Yan;Ye Xiang;Ma Lin;Shan Peiyan(Department of Geriatric Neurology, Qilu Hospital of Shandong University, Jinan 250012, China)

机构地区：[1]山东大学齐鲁医院老年神经内科,济南250012

出　　处：《中华老年医学杂志》2019年第3期304-308,共5页Chinese Journal of Geriatrics

摘　　要：报道1例84岁老年男性患者以头晕为主诉入院,合并桥本氏甲状腺炎、自身免疫性胃炎及白癜风等慢性疾病,体格检查可见皮肤色素脱失斑,实验室检查显示贫血、内因子抗体阳性、肾上腺功能正常,最终被诊断为自身免疫性多腺体综合征(APS)ⅢB+C型。患者反复发作贫血与自身免疫性胃炎所致的吸收障碍有关。现复习APS常见临床表现,提示老年科医生应关注异质性强的这类疾病,老年患者同时存在白癜风和贫血需考虑APSⅢB+C的可能。This report presents an 84 year-old patient admitted into our hospital for dizziness with a history of Hashimoto's thyroiditis, chronic gastritis and vitiligo.Physical examinations showed skin depigmentation.Laboratory tests revealed anemia, positive intrinsic factor antibodies and normal adrenal function.This patient was finally diagnosed with autoimmune polyglandular syndromes(APS)type Ⅲ B+ C.Recurrent anemia was mainly attributed to malabsorption caused by autoimmune gastritis.This article reviews the common clinical manifestations of APS, in order to call for geriatricians' attention to APS.APS Ⅲ B+C should be considered if vitiligo combined with anemia occurs in elderly patients.

关 键 词：自身免疫疾病 贫血 白瘢风 胃炎 

分 类 号：R593.2[医药卫生—内科学]