皮肌炎合并食管黏膜剥脱1例  

Dermatomyositis with exfoliation of esophageal mucosa:A case report

作　　者：郑玮 张浩[1] 张显明[1] 刘妍[1] ZHENG Wei;ZHANG Hao;ZHANG Xianming;LIU Yan(Department of Nephrology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院肾内科,长沙410013

出　　处：《中南大学学报（医学版）》2021年第1期104-107,共4页Journal of Central South University ：Medical Science

摘　　要：皮肌炎(dermatomyositis,DM)是一种特发性炎症性肌病,以慢性近端骨骼肌无力、独特的皮肤损害为特征。皮肌炎合并食管黏膜剥脱临床上少见。1例36岁男性患者因"四肢肌肉酸痛、吞咽困难及咽痛"入院,被诊断为DM合并食管黏膜剥脱。患者经过糖皮质激素、免疫抑制剂、针灸及内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗,上述症状消失。在3年的随访期内,常规体检、实验室检查、胃镜检查和影像学检查结果均正常。此类患者治疗初期需使用大剂量糖皮质激素,之后应逐渐减量以避免激素不良反应。另外,针灸和ESD作为辅助治疗手段亦有一定效果。Dermatomyositis(DM)is a kind of idiopathic inflammatory myopathy characterized by chronic proximal skeletal muscle weakness and unique skin lesions.However,DM with exfoliation of esophageal mucosa is rare.A 36-year-old male patient complained of muscular soreness of extremities,dysphagia,and pharyngalgia was diagnosed with DM with exfoliation of esophageal mucosa.After treatment with glucocorticoid,immunosuppressant,acupuncture,and endoscopic submucosal dissection(ESD),the above symptoms were disappeared.During the 3-year follow-up period,the results of routine physical examination,laboratory examination,gastroscopy,and imaging examination were normal.High-dose of corticosteroid is needed in the initial treatment,but it must be reduced regularly to avoid adverse reactions.Acupuncture and ESD are also effective as adjuvant therapy.

关 键 词：皮肌炎 食管黏膜剥脱 吞咽困难 糖皮质激素 针灸 内镜黏膜下剥离术 

分 类 号：R571[医药卫生—消化系统] R593.26[医药卫生—内科学]