摘要
目的对缓解性血清阴性对称性滑膜炎伴凹陷水肿(RS3PE)的临床和实验室特点以及治疗和预后进行分析,提高对该病的认识。方法收集蚌埠医学院第一附属医院2004年1月至2011年5月就诊的RS3PE患者共5例,其中住院患者4例、门诊患者1例。分析其临床表现、实验室特点、治疗反应及转归,并对文献进行复习。结果 5例患者均急性起病,有对称性多关节炎及肢端水肿。5例患者起病时红细胞沉降率(59.6±29.0)mm/h,C反应蛋白(78.7±28.8)mg/L,血白细胞(10.25±1.92)×109/L,血红蛋白(87.4±6.26)g/L,血小板(487.2±148.4)×109/L,血清类风湿因子、抗环瓜氨酸多肽抗体、抗核抗体均为阴性。双手X线均未见骨侵蚀性改变。5例患者经泼尼松和/或免疫抑制剂治疗后完全缓解,其中3例完全停药,1例在1年后复发诊断为急性粒-单核细胞白血病。结论 RS3PE是一种异质性临床症候群,可能是单纯的独立疾病,也可发展为自身免疫性疾病或肿瘤,临床上应保持警惕。
Objective This study investigate the clinical and laboratory features of remitting seronegative symmetrical synovitis with pitting edema（RS3PE）,and describe the following treatment and outcome.Methods 5 clinical datas of RS3PE from the first affiliated hospital of Beng Bu medical college were enrolled in this study.The clinical features,laboratory tests,response to treatment as well as the outcomes and literature were reviewed.Results Among the 5 patients,three were females and 2 were males,the mean age of onset was 54.0（44-65 years）.In all patients,the onset was acute or sudden,with symmetrical polyarthritis and pitting edema on the dorsum of hands and/or feet.The Mean±SD of erythrocyte sedimentation rate,C-reactive protein,leucocye count,hemoglobin and platelet count were（59.6±29.0）mm/h,（78.7±28.8）mg/L,（10.25±1.92）×109/L,（87.4±6.26）g/L and（487.2±148.4）×109/L respectively.Serum rheumatoid factor,anticyclic citrullinated peptide antibody and antinuclear antibody were negative.Hand radiographs did not show bone erosion in all cases.After treatment with steroid and/or immunosuppressive pharmacy,5 cases exhibited complete remission and 3 of them did not need anymore therapy.One case relapsed one year later and developed acute myelomonocytic leukemia.Conclusions RS3PE is a group of clinical manifestations characterized with prominent heterogeneity.RS3PE may be a simple unique disease,however,it may developed into autoimmune or even malignant diseases sometimes.thereby,intensive follow-up is necessary.
出处
《中华临床免疫和变态反应杂志》
2011年第4期307-312,共6页
Chinese Journal of Allergy & Clinical Immunology
