少见的以1型糖尿病合并Graves甲亢为表现的自身免疫性多腺体综合征2型合并罕见的僵肢综合征一例报道  

A rare autoimmune polyglandular syndrome type 2 presented with T1DM and Graves’ hyperthyroidism complicated with stiff limbs syndrome: a case report

作　　者：潘鑫 刘芳[2] 史晓光[1] 王晓黎[1] 王秋月[1] PAN Xin;LIU Fang;SHI Xiaoguang(Department of Endocrinology and Metabolism,The First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院内分泌与代谢病科,沈阳110001 [2]中国医科大学附属第一医院神经内科,沈阳110001

出　　处：《中国糖尿病杂志》2022年第6期452-455,共4页Chinese Journal of Diabetes

基　　金：国家重点研发计划项目(2018YFC1313900、2018YFC1313901)。

摘　　要：T1DM合并僵人综合征(SPS)非常罕见,以进行性肌肉强直和痉挛为特征。僵肢综合征(SLS)是SPS的1个亚型,常与自身免疫性疾病共存。本文报道1例SLS合并自身免疫性多腺体综合征2型,包括T1DM及Graves病。患者胰岛功能几乎完全丧失,促甲状腺自身抗体升高,GAD65抗体在血清及脑脊液中均为阳性。予胰岛素强化、甲巯咪唑、地西泮、巴氯芬及甲强龙冲击治疗后,神经系统症状改善明显。Type 1 diabetes(T1DM)complicated with Stiff person syndrome(SPS)is very rare,characterized by progressive muscle rigidity and spasm. Stiff limb syndrome(SLS)is a subtype of SPS,often coexists with autoimmune diseases. Here we reported a rare case of SLS with autoimmune polyglandular syndrome type 2,which includes T1DM and Graves’ disease. The patient had almost complete loss of islet function and increased level of TRAb. The GAD 65 antibody was positive in serum and cerebrospinal fluid.The patient’s neurological symptoms improved significantly after treatment of intensive insulin therapy,methimazole,diazepam,baclofen,and methylprednisolone pulse therapy.

关 键 词：僵肢综合征 糖尿病 1型 GRAVES病 GAD抗体 

分 类 号：R587.1[医药卫生—内分泌] R581.1[医药卫生—内科学]