■混合性结缔组织病(MCTD)的特征是高滴度的不同抗体:U1核糖核蛋白在类风湿性关节炎中具有可变的临床特征,系统性红斑狼疮,硬皮病,多发性肌炎,和皮肌炎.有限的病例报告揭示了MCTD和癌症之间的关联,比如淋巴瘤,肺癌,和其他人。
■一名22岁女性表现为腹部增大和下肢水肿,逐渐开始25天患者被诊断患有类风湿性关节炎。她用7.5mg/周MTX治疗6个月。体检显示:苍白,下肢水肿,有滑膜炎和手畸形.实验室检查显示贫血,肌酸磷酸激酶ESR水平升高,抗核抗体阳性,反dsDNA,和抗核核糖核蛋白。尿蛋白排泄量为1625mg/24h。胸片显示双侧胸腔积液。超声心动图显示心包积液胸腹和盆腔断层扫描显示直径为5×6cm的异质肿块,以右侧卵巢为代价。肿块是通过手术切除的,做了活检,与卵巢高级别浆液性腺癌相容。使用solumedrol1g/IV/3天的疗程,然后继续口服60毫克/天的predlone。后来出院时,她每天服用25毫克predlone,和甲氨蝶呤10毫克。
■我们的病例显示患者没有发生卵巢癌的危险因素。相反,我们的病人很年轻,非吸烟者,在RA诊断之前没有任何治疗,最后,她有3个足月怀孕的孩子,和健康。此病例凸显了在MCTD患者中保持高度怀疑恶性肿瘤的重要性。然而,在患有包括MCTD在内的自身免疫性疾病的女性中,仍有必要进一步研究免疫系统在卵巢癌发展中的作用.
UNASSIGNED: Mixed connective tissue disease (MCTD) is characterized by high titres of distinct antibodies: U1 ribonucleoprotein with variable clinical features seen in rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis, and dermatomyositis. Limited
case reports revealed the association between MCTD and cancer, like lymphoma, lung cancers, and others.
UNASSIGNED: A 22-year-old female presented with enlargement of the abdomen and oedema of the lower extremities, gradually started 25 days The patient had been diagnosed to have rheumatoid arthritis. She was treated with 7.5 mg/week MTX for 6 months. Physical examination revealed: pallor, lower limb oedema, with synovitis and deformities of hands. The laboratory tests showed anaemia, elevated levels of creatine phosphokinase ESR, positivity of antinuclear antibody, anti-ds DNA, and antinuclear ribonucleoprotein. Urinary protein excretion was 1625 mg/24 h. Chest X-ray showed bilateral pleural effusion. Echocardiography revealed pericardial effusion Thoracic-abdominal and pelvic tomography showed a heterogeneous mass with a diameter of 5 × 6 cm at the expense of the right ovary. The mass was removed surgically, and a biopsy was taken, and was compatible with ovarian high-grade serous adenocarcinoma. A course of solumedrol 1 g/IV/3 days was applied, and then continue with 60 mg/day oral predlone. Later on discharge, she was taken 25 mg/day predlone, and methotrexate 10 mg.
UNASSIGNED: Our
case showed that the patient had no risk factors for developing ovary cancer. On the contrary, our patient was a young, non-smoker, without any previous treatment before the RA diagnosis was taken, and finally, she had 3 children with full-term pregnancy, and well health. This
case highlights the importance of maintaining a high index of suspicion for malignancy in MCTD patients. However, further investigation on the role of the immune system in the development of ovarian cancer in women with autoimmune diseases including MCTD remains necessary.