关节受累为首发症状的系统性红斑狼疮1例报道  

Systemic lupus erythematosus with joint involvement as the first symptom:A case report

作　　者：陈尚韬 刘峰[1] 李双庆[1] CHEN Shangtao;LIU Feng;LI Shuangqing(Department of General Practice,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院全科医学科,四川成都610041

出　　处：《中华全科医学》2023年第10期1810-1812,共3页Chinese Journal of General Practice

摘　　要：本文报道了1例67岁的老年男性患者,5余年的腰膝关节疼痛病史,既往多个医疗机构完善各类相关检查均未查明病因,仅使用对症止痛及康复治疗,症状缓解不明显。入院后查见双手皮损及抗核抗体阳性,考虑系统性红斑狼疮,完善相关检查后确定为该诊断,针对性治疗后好转出院。该病例提示系统性红斑狼疮起病可隐匿,缺乏典型表现,对以关节受累为起病症状的系统性红斑狼疮的诊断是较为困难的,提示临床医生面对不典型关节症状,视情况筛查免疫系统疾病,早发现、早诊断、早治疗。This paper reported a 67-year-old male patient with a history of lumbar and knee pain for more than 5 years,and no cause was found after various relevant examinations in multiple medical institutions,only with symptomatic pain relief and rehabilitation treatment,the symptoms were not significantly relieved.After admission,skin lesions on both hands and positive antinuclear antibody were found,systemic lupus erythematosus was considered.After the improvement of relevant examinations,the diagnosis was confirmed,after targeted treatment,the patient improved and was discharged.This case suggests that the onset of systemic lupus erythematosus can be insidious,lacking typical manifestations,and it is difficult to make a diagnosis of systemic lupus erythematosus with joint involvement as the initial symptom.It is suggested that clinicians should screen for immune system diseases according to the situation in the face of atypical joint symptoms for early detection,early diagnosis and early treatment.

关 键 词：系统性红斑狼疮 关节炎 抗核抗体ANA 

分 类 号：R593.241[医药卫生—内科学]