妊娠性类天疱疮  

A case of pemphigoid gestationis

作　　者：王华[1] 韩世新[1] 邹唯怡 周梅娟[1] WANG Hua;HAN Shi-xin;ZOU Wei-yi;ZHOU Mei-juan(Department of Dermatology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院皮肤科,辽宁大连116011

出　　处：《临床皮肤科杂志》2021年第6期351-353,共3页Journal of Clinical Dermatology

摘　　要：报告1例妊娠性类天疱疮。患者女,30岁。因周身红斑伴瘙痒1个月余,加重伴水疱和灼痛6d入院。皮肤科检查:周身可见水肿性红斑,其上密集大小不等的厚壁水疱,尼氏征阴性。抗核抗体(ANA)、抗双链(ds)-DNA抗体、抗桥粒芯糖蛋白(Dsg)1抗体、抗Dsg3抗体、抗BP180抗体及抗BP230抗体均阴性。直接免疫荧光(DIF)示基膜带IgG呈线状沉积,IgA、IgM及C3阴性。皮损组织病理检查:表皮下水疱形成,真皮血管周围及间质可见嗜酸性粒细胞和淋巴细胞等浸润。诊断:妊娠性类天疱疮;晚期妊娠33^(+1)周,孕1产0左枕前位(G1P0 LOA)。剖宫早产活婴后,予甲泼尼龙联合静脉注射用人免疫球蛋白(IVIG)冲击治疗。A case of pemphigoid gestationis is reported. A 30-year-old pregnant patient was admitted for widely distributed and aggravating pruritic erythema for over a month and blisters and burning pain lasting for 6 days. Dermatological examination showed irregular-sized thick wall blisters on edematous erythemas on the entire body. Nikolsky’s sign was negative. Laboratory analysis revealed negative findings in ANA, anti-ds-DNA antibodies, anti-Dsg1 antibodies, anti-Dsg3 antibodies, anti-BP180 antibodies and anti-BP230 antibodies. DIF showed linear deposits of IgG along the basement membrane zone, while IgA, IgM and C3 were negative. Histopathological examination showed subepidermal blisters with perivascular infiltration of eosinophils and lymphocytes. The patient was diagnosed with pemphigoid gestationis in late pregnancy at 33^(+1) week’s gestation(G1 P0 LOA). Impulse therapy of methylprednisolone combined with IVIG was conducted after premature delivery by cesarean section.

关 键 词：类天疱疮 妊娠性 

分 类 号：R714.2[医药卫生—妇产科学] R752.1[医药卫生—临床医学]