摘要
目的报道国内首例强直性脊柱炎合并腹膜后纤维化病例的临床过程。方法对1例在诊断强直性脊柱炎15年后确诊为腹膜后纤维化患者的临床和随诊资料进行分析,并对相关文献进行复习。结果经过查新,强直性脊柱炎合并腹膜后纤维化在我国尚属首例。腹膜后纤维化可以与强直性脊柱炎同时发病,也可以在强直性脊柱炎发病数年后出现。该患者在使用糖皮质激素和他莫昔芬治疗1个月后,肾盂、输尿管病变明显减轻。结论强直性脊柱炎是一种常见风湿免疫疾病,近来将腹膜后纤维化也定性为风湿免疫疾病,二者可以同时出现,并且认为腹膜后纤维化是强直性脊柱炎的关节外表现之一。临床医师应该认识到二者的关系,及早发现、及早诊治,以挽救重要脏器功能。
Objective To report a case of ankylosing spondylitis complicated with retroperitoneal fibrosis 15 years later and the relevant literature were reviewed. Methods The clinical history of a 52 year-old male patient with ankylosing spondylitis who was diagnosed to have retroperitonel fibrosis 15 years later was described. The related literature about ankylosing spondylitis and retroperitoneal fibrosis were reviewed. Results This is the first case of ankylosing spondylitis complicated with retropefitoneal fibrosis reported in China. This patient was diagnosed to have ankylosing spondylitis 15 years ahead of the discovery of retroperitoneal fibrosis. When retroperitoneal fibrosis was diagnosed, his spondylitis was in the end stage. Corticosteroid and tamoxffen were used to treat the retroperitoneal fibrosis. One month later, his hydronephrosis was relieved and the serum acute phase reactant returned to normal level. Conclusions Only less than 20 ankylosing spondylitis complicated with retroperitoneal fibrosis cases were reported in the whole world. This is the first such case reported in China. Retroperitoneal fibrosis is considered to be an extra-articular manifestation of ankylosing spondylitis. It can present at the same time, before or after the diagnosis of ankylosing spondylitis. When an ankylosing spondylitis patient presents with hydronephrosis, which is usually the first finding, retroperitoneal fibrosis should be considered and the relevant examinations should be performed. Corticosteroid, combined with immunosuppressive agents or tamoxifen as well as ureterolysis or ureter intubation,if hydronephrosis presents, is the effective treatment and can save renal function.
出处
《北京医学》
CAS
2006年第4期202-205,共4页
Beijing Medical Journal
关键词
脊柱炎
强直性
腹膜后纤维化
特发性
糖皮质激素
他莫昔芬
Spondylitis, ankylosing Retroperitoneal fibrosis, idiopathic Corticosteroids Tamoxifen
