{"title":"迟发性系统性红斑狼疮肺部表现1例","authors":"T. Kalenchic, N. Didenko, S. Kabak","doi":"10.35465/27.4.2019.pp63-66","DOIUrl":null,"url":null,"abstract":"The current report presents a case of late-onset systemic lupus erythematosus (SLE). A 75-year-old Caucasian woman was admitted to the clinical hospital because of dyspnea, dry cough, low-grade fever, wrist pain. There were no oral and skin lesions or lymphadenopathy observed. Laboratory tests revealed hypochromic microcytic anemia with hemoglobin 111 g/l, lymphopenia 0,54 x 10/l, the erythrocyte sedimentation rate (ESR) elevation up to 47 mm/h and the C-reactive protein level up to 10,7 mg/l. Tumor markers (CA-125, CA-19.9, СА-15,3, α-fetoprotein) concentration, hepatic and renal function were within the reference ranges. Of note, urinalysis didn’t reveal proteinuria or microscopic hematuria and was considered normal. Computed tomography revealed bilateral pulmonary consolidation in S10, sacculated pleuritis, solitary lymphadenopathy, and pericardial effusions. Diagnosis of SLE was confirmed based on three clinical signs (synovitis of proximal interphalangeal joints, serositis including pleuritis, hematological disorders: anemia, lymphocytopenia) and positive findings of three immunological tests (anti-double-stranded DNA antibodies [Anti-dsDNA], antinuclear antibodies [ANA], and anti-nucleosome antibodies [ANuA]). This case demonstrates that late-onset SLE may be one of the reasons for the accumulation of pleural fluid in elderly patients.","PeriodicalId":38954,"journal":{"name":"Revmatologiia (Bulgaria)","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pulmonary manifestations of late-onset systemic lupus erythematosus: a case report\",\"authors\":\"T. Kalenchic, N. Didenko, S. Kabak\",\"doi\":\"10.35465/27.4.2019.pp63-66\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The current report presents a case of late-onset systemic lupus erythematosus (SLE). A 75-year-old Caucasian woman was admitted to the clinical hospital because of dyspnea, dry cough, low-grade fever, wrist pain. There were no oral and skin lesions or lymphadenopathy observed. Laboratory tests revealed hypochromic microcytic anemia with hemoglobin 111 g/l, lymphopenia 0,54 x 10/l, the erythrocyte sedimentation rate (ESR) elevation up to 47 mm/h and the C-reactive protein level up to 10,7 mg/l. Tumor markers (CA-125, CA-19.9, СА-15,3, α-fetoprotein) concentration, hepatic and renal function were within the reference ranges. Of note, urinalysis didn’t reveal proteinuria or microscopic hematuria and was considered normal. Computed tomography revealed bilateral pulmonary consolidation in S10, sacculated pleuritis, solitary lymphadenopathy, and pericardial effusions. Diagnosis of SLE was confirmed based on three clinical signs (synovitis of proximal interphalangeal joints, serositis including pleuritis, hematological disorders: anemia, lymphocytopenia) and positive findings of three immunological tests (anti-double-stranded DNA antibodies [Anti-dsDNA], antinuclear antibodies [ANA], and anti-nucleosome antibodies [ANuA]). This case demonstrates that late-onset SLE may be one of the reasons for the accumulation of pleural fluid in elderly patients.\",\"PeriodicalId\":38954,\"journal\":{\"name\":\"Revmatologiia (Bulgaria)\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revmatologiia (Bulgaria)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.35465/27.4.2019.pp63-66\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revmatologiia (Bulgaria)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.35465/27.4.2019.pp63-66","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
本文报告一例迟发性系统性红斑狼疮(SLE)。一名75岁白人妇女因呼吸困难、干咳、低烧、手腕疼痛入院。未见口腔及皮肤病变及淋巴结病变。实验室检查显示低色性小细胞贫血,血红蛋白111 g/l,淋巴细胞减少0.54 x 10/l,红细胞沉降率(ESR)升高高达47 mm/h, c反应蛋白水平高达10.7 mg/l。肿瘤标志物(CA-125、CA-19.9、СА-15、3、α-胎蛋白)浓度及肝肾功能均在参考范围内。值得注意的是,尿分析没有发现蛋白尿或显微镜下血尿,认为是正常的。计算机断层扫描显示S10双侧肺实变、囊状胸膜炎、孤立性淋巴结病和心包积液。根据三个临床症状(近端指间关节滑膜炎、包括胸膜炎的浆液炎、血液学疾病:贫血、淋巴细胞减少症)和三种免疫检查(抗双链DNA抗体[Anti-dsDNA]、抗核抗体[ANA]、抗核小体抗体[ANuA])阳性结果,确认SLE的诊断。本病例提示迟发性SLE可能是老年患者胸腔积液的原因之一。
Pulmonary manifestations of late-onset systemic lupus erythematosus: a case report
The current report presents a case of late-onset systemic lupus erythematosus (SLE). A 75-year-old Caucasian woman was admitted to the clinical hospital because of dyspnea, dry cough, low-grade fever, wrist pain. There were no oral and skin lesions or lymphadenopathy observed. Laboratory tests revealed hypochromic microcytic anemia with hemoglobin 111 g/l, lymphopenia 0,54 x 10/l, the erythrocyte sedimentation rate (ESR) elevation up to 47 mm/h and the C-reactive protein level up to 10,7 mg/l. Tumor markers (CA-125, CA-19.9, СА-15,3, α-fetoprotein) concentration, hepatic and renal function were within the reference ranges. Of note, urinalysis didn’t reveal proteinuria or microscopic hematuria and was considered normal. Computed tomography revealed bilateral pulmonary consolidation in S10, sacculated pleuritis, solitary lymphadenopathy, and pericardial effusions. Diagnosis of SLE was confirmed based on three clinical signs (synovitis of proximal interphalangeal joints, serositis including pleuritis, hematological disorders: anemia, lymphocytopenia) and positive findings of three immunological tests (anti-double-stranded DNA antibodies [Anti-dsDNA], antinuclear antibodies [ANA], and anti-nucleosome antibodies [ANuA]). This case demonstrates that late-onset SLE may be one of the reasons for the accumulation of pleural fluid in elderly patients.