Abstract:
We present the case of a 30-year-old woman who presented with 8-month history of intermittent fever, joint pains with morning stiffness, recurrent oral ulcers, photosensitivity, weight loss and hair fall. For the last 2 months, she had developed a dry cough with progressive shortening of breath. On examination, a cachexic lady with malar hyperpigmentation, alopecia, pallor, nail dystrophy and erythema over her hands and feet were noted. There were multiple punched-out skin ulcers of variable size over legs, arms and abdomen usually round in shape with well-defined even wound margins and scant serous discharge. Musculoskeletal examination revealed synovitis of both elbows and a few metacarpophalangeal and proximal interphalangeal joints. Chest X-ray and HRCT showed bilateral ground-glass opacification. Anti-Nuclear Antibody (ANA) was positive, 1:320, homogenous nuclear pattern. Anti-Ro antibody was highly positive and serum complement (C3, C4) levels were reduced. She was diagnosed with Lupus Vasculitis and started on steroids, mycophenolate mofetil and hydroxychloroquine.
摘要:
我们介绍了一名30岁的女性,她有8个月的间歇性发热史,关节疼痛与晨僵,复发性口腔溃疡,光敏性,体重下降和头发下降。在过去的两个月里,她出现干咳,呼吸逐渐缩短。在检查中,一位患有黄斑色素沉着的恶病质女士,脱发,苍白,注意到她的手脚上有指甲营养不良和红斑。腿部有多个大小可变的穿孔皮肤溃疡,手臂和腹部通常呈圆形,伤口边缘清晰均匀,浆液性分泌物很少。肌肉骨骼检查显示肘部和一些掌指关节和近端指间关节滑膜炎。胸部X线及HRCT显示双侧毛玻璃混浊。抗核抗体(ANA)呈阳性,1:320,同质核模式。抗Ro抗体呈高度阳性,血清补体(C3,C4)水平降低。她被诊断出患有狼疮血管炎并开始服用类固醇,霉酚酸酯和羟氯喹。