抗Jo-1抗体和抗SRP抗体共存皮肌炎并发干燥综合征1例报告及文献复习  

Coexistence of anti-Jo-1 and anti-SRP antibodies in dermatomyositis complicated with Sjogren’s syndrome:A case report and literature review

作　　者：谭声海 袁艺[1] 张彦东[1] 谷三炜 姜振宇[1] TAN Shenghai;YUAN Yi;ZHANG Yandong;GU Sanwei;JIANG Zhenyu(Department of Rheumatology and Immunology,First Hospital,Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院风湿免疫科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2022年第4期1028-1034,共7页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金青年基金项目(82101032)。

摘　　要：目的:分析1例抗Jo-1抗体和抗信号识别颗粒(SRP)抗体共存皮肌炎(DM)并发干燥综合征(SS)患者的临床表现和诊疗经过,为该类罕见疾病的诊治提供参考。方法:收集1例抗Jo-1抗体和抗SRP抗体并存DM并发SS患者的临床资料,记录各项信息,包括患者性别、发病年龄、临床表现、实验室资料和随访信息等,对临床资料进行回顾性分析,并结合相关文献进行归纳复习。结果:患者,女性,52岁,因间断咳嗽、咳痰和气短伴全身乏力2个月,门诊以“间质性肺炎”收入院,双手轻度“技工手”样改变,四肢肌力3级。实验室检查,血清肌酸激酶水平明显升高,抗Jo-1抗体和抗SRP抗体阳性,影像学提示肺间质改变,肌肉病理学检查提示肌肉组织萎缩、变性和炎细胞浸润,唇腺病理学检查提示为口腔干燥症,临床诊断为DM并发SS,给予糖皮质激素联合吗替麦考酚酯治疗后病情好转出院。随访5个月,患者血清肌酸激酶水平降至正常,DM临床症状明显改善。结论:双抗体阳性DM并发SS发病率低,患者临床表现不典型,易累及肺脏,临床表现、病理检查和肌酶谱检测是诊断该病的主要依据,本例患者采用糖皮质激素联合免疫抑制剂治疗方案有效。在此类患者治疗过程中应定期随访。Objective:To analyze the clinical manifestations and diagnosis and treatment process of a patient with dermatomyositis complicated with Sjogren’s syndrome with coexistence of anti-Jo-1 and anti-SRP antibodies,and to provide reference for the diagnosis and treatment of this rare case.Methods:The clinical materials of the patient with dermatomyositis complicated with Sjogren’s syndrome with coexistence of anti-Jo-1 and anti-SRP antibodies were collected,all kinds of information,including gender,age of onset,clinical manifestations,laboratory data and follow-up information were recorded,and the clinical data were retrospectively analyzed and the related literature were reviewed.Results:The female patient aged 52 years old was admitted to hospital because of“interstitial pneumonia”due to intermittent cough,expectoration,shortness of breath and general weakness for 2 months.The patient’s hands had mild“mechanic’s hands”like changes,and the limb muscle strength was grade 3.The laboratory examination showed that the creatine kinase level was increased significantly,and anti-Jo-1 antibody and anti-SRP antibody were positive;the imaging results showed the pulmonary interstitial changes;the muscle pathological results showed atrophy,degeneration and inflammatory cell infiltration,and the labial gland pathology showed xerostomia;the clinical diagnosis was DM complicated with SS.After treatment with glucocorticoid combined with mycophenolate mofetil,the condition was improved and the patient was discharged from the hospital.The patient was followed up for 5 months,the creatine kinase level was completely decreased to normal,and the clinical symptoms of DM were significantly improved.Conclusion:Double myositis-specific autoantibodies positive DM complicated with SS has a low incidence,and its clinical manifestations are atypical and easily involve the lung;the clinical manifestations,pathological examination and muscle zymography test are the mainstays for the diagnosis of this disease,and in this patient gluc

关 键 词：特发性炎性肌病 抗JO-1抗体 抗信号识别颗粒抗体 皮肌炎 干燥综合征 

分 类 号：R593.26[医药卫生—内科学]