系统性硬化症合并强直性脊柱炎1例及文献复习

摘要

系统性硬化症是一种以皮肤增厚和纤维化为特征的自身免疫性疾病,强直性脊柱炎是一种以中轴关节受累为主的关节炎,强直性脊柱炎极少与弥漫性结缔组织病合并存在.既往文献报道了5例强直性脊柱炎合并系统性硬化症的病例,其中仅1例患者诉有肌无力,且5例患者的血清肌酸激酶水平均无明显异常.本文报道1例青年男性患者符合系统性硬化症与强直性脊柱炎的诊断标准,同时出现肌无力、肌酸激酶水平明显增高.人类白细胞抗原(humanleukocyte antigen,HLA)分型检测发现该患者携带这两种疾病的HLA易感基因.对该患者予以强的松30 mg/d及环磷酰胺治疗,2个月后皮肤增厚好转,肌酸激酶降至正常.%Systemic sclerosis (SSc) is an autoimmune disease characterized by thickening of the skin and organ fibrosis.Ankylosing spondylitis (AS) is a type of arthritis with long-term inflammation of the axial joints.Previous studies presented 5 cases of concomitant AS and SSc.However,there was only 1 patient of those 5 cases complaining of muscle weakness while all patients had approximately normal creatine kinase (CK).Here we reported a young male who met the criteria for SSc and AS while showing significantly elevated CK.Human leukocyte antigen (HLA) typing results indicated the genetic susceptibility to these two diseases.The patient was prescribed prednisone (30 mg/d)and cydophosphamide.After 2 months,the patient's skin became soft with normal CK.