12岁女孩,系统性红斑狼疮并发坏疽和间歇性跛行。

IF 0.9 Q4 RHEUMATOLOGY
Takashi Uechi, Tomoko Horinouchi, Yuta Inoki, Yu Tanaka, Hideaki Kitakado, Chika Ueda, China Nagano, Masato Yamaguchi, Yoriko Tsuji, Kandai Nozu
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引用次数: 0

摘要

系统性红斑狼疮(SLE)可呈现多种症状,包括坏疽等罕见表现。本报告描述了一个12岁的SLE女孩,她表现为间歇性跛行和坏疽。虽然间歇性跛行在儿科病例中很少见,但必须考虑血管疾病,包括与SLE相关的血管疾病,作为潜在的原因。患者最初出现右大脚趾疼痛、发红和冷感,并伴有间歇性跛行,症状随着时间的推移而恶化。诊断影像,包括增强CT和MRI,显示右侧腘动脉闭塞并伴有血管炎和血栓形成。根据临床标准确诊SLE及抗磷脂综合征。治疗包括强的松、甲基强的松脉冲治疗、霉酚酸酯、羟氯喹和抗凝血剂。患者表现出明显的改善,通过免疫抑制治疗和仔细的伤口护理,跛行和坏疽得到了有效的治疗。这个病例强调了在小儿SLE中考虑血管并发症的重要性,并强调了早期诊断和综合治疗的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
12-Year-old girl with systemic lupus erythematosus complicated by gangrene and intermittent claudication.

Systemic lupus erythematosus (SLE) can present with various symptoms, including rare manifestations such as gangrene. This report describes a 12-year-old girl with SLE who presented with intermittent claudication and gangrene. Although intermittent claudication is rare in paediatric cases, it is essential to consider vascular diseases including those associated with SLE as a potential cause. The patient initially experienced pain, redness, and cold sensations in the right great toe accompanied by intermittent claudication, with symptoms worsening over time. Diagnostic imaging, including contrast-enhanced computed tomography and magnetic resonance imaging, revealed occlusion of the right popliteal artery with associated vasculitis and thrombosis. The diagnosis of SLE and antiphospholipid syndrome was confirmed based on clinical criteria. Treatment included prednisone, methylprednisolone pulse therapy, mycophenolate mofetil, hydroxychloroquine, and anticoagulants. The patient showed significant improvement, with resolution of claudication and effective management of her gangrene through immunosuppressive therapy and careful wound care. This case highlights the importance of considering vascular complications in paediatric SLE and underscores the need for early diagnosis and comprehensive treatment.

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