干燥综合征合并色素沉着绒毛结节性滑膜炎1例并文献复习
李思泽1 周唯践2 殷世云2 官鑫1 冯亚琼1 丁珊2 陈艳林2 汤小虎2
1.云南中医药大学第一临床医学院,云南昆明 650011;
2.云南省中医医院风湿科,云南昆明 650021
A case of Sjögren’s syndrome complicated with pigmented villonodular synovitis and literature review
LI Size1 ZHOU Weijian2 YIN Shiyun2 GUAN Xin1 FENG Yaqiong1 DING Shan2 CHEN Yanlin2 TANG Xiaohu2
1.The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Yunnan Province, Kunming 650011, China;
2.Department of Rheumatology, the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Yunnan Province, Kunming 650021, China
摘要 干燥综合征(SS)是主要累及外分泌腺的炎症性自身免疫性疾病,除眼干、口干等外分泌腺表现外,临床常见合并肺间质纤维化,少见合并色素绒毛结节性滑膜炎(PVNS)。PVNS是临床中的少见疾病,具有炎症与肿瘤的双重特征,临床表现无特异性,发病时常有关节肿胀、疼痛与活动受限,PVNS临床容易误诊,病理检查是诊断PVNS的金标准,手术切除受累的关节滑膜是治疗PVNS的主要方式,放射治疗可作为本病的术后辅助治疗。本文报道1例以左下肢酸胀疼痛为首要临床表现伴眼干、口干,同时反复出现左膝血性关节积液的患者,经组织病理检查,最终确诊同时存在SS与PVNS两种疾病,并回顾以往文献,以期为临床诊断与中西医结合治疗本病提供参考。
关键词 :
干燥综合征 ,
色素沉着绒毛结节性滑膜炎 ,
病例报道 ,
罕见病
Abstract :Sjögren’s syndrome (SS) belongs to an inflammatory autoimmune disease mainly involving exocrine glands, in addition to exocrine gland manifestations such as dry eyes and dry mouth, pulmonary interstitial fibrosis is common clinically, and pigmented villonodular synovitis (PVNS) is rare. PVNS is a rare disease in clinical practice, with dual characteristics of inflammation and tumor, non-specific clinical manifestations, frequent joint swelling, pain, and limited activity at the onset of disease. Clinical misdiagnosis of PVNS is easy, pathological examination is the gold standard for diagnosis of PVNS, and surgical resection of the affected joint synovium is the main treatment for PVNS. Radiotherapy can be used as postoperative adjuvant therapy for this disease. In this paper, a patient with left lower limb distension and pain as the primary clinical manifestations accompanied by dry eyes and mouth and recurrent bloody joint effusion in the left knee was reported. After histomathological examination, SS and PVNS were confirmed to be present at the same time. The previous literature was reviewed in order to provide reference for clinical diagnosis and treatment of this disease with integration of Chinese and western medicine.
Key words :
Sjögren’s syndrome
Pigmented villonodular synovitis
Case report
Rare diseases
基金资助: 国家自然科学基金资助项目(81560770);
云南省卫生健康委员会云南省人力资源和社会保障厅“万人计划”名医专项;
云南省卫生科技计划项目(2018NS0042);
云南省教育厅科学研究基金项目(2021Y457)。
通讯作者:
汤小虎(1964-),男,博士,主任医师,博士生导师;研究方向:风湿病的中医防治及临床方药配伍规律。
作者简介 : 李思泽(1996-),男,云南中医药大学第一临床医学院2020级中医内科学专业在读硕士研究生;研究方向:风湿病的中医防治。
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