论文部分内容阅读
类风湿性关节炎(RA)病人产生结节病的报告很少见,以往仅有8例文献报道。本文报告2例 RA 病人发生结节病,且均有 HLA 抗原 DR_4和干燥综合征。病例介绍 2例 RA 病人均为年轻女性,1例患 RA 13年,另1例病史10个月。2例病人入院时均有劳累后呼吸困难、眼干和嘴干的表现。实验室检查均为正色素性正细胞性贫血,类风湿因子阳性,补体正常,γ-球蛋白片段多克隆增加,IgG、IgM、IgA 均高于正常值,血管紧张素转换酶(ACE)增高,HLA 分型显示为其表型 DR_4。1例胸部 X 线示肺间质网状结节样改变,肺功能为限制性损害,最大肺活量(FVC)减低,一秒用力呼气量(FEV_1)呈轻、中度减退。FEV_1/FVC 正常,总肺活量正常,功能残气量(FRC)减低。另1例胸部 X 线示双肺门淋巴结肿大。肺功能包括 CO 弥散量正常。两例经支
There are only a few reports of sarcoidosis in patients with rheumatoid arthritis (RA), as reported in only 8 cases in the past. This article reports two cases of RA patients with sarcoidosis, and have HLA DR4 and Sjogren’s syndrome. Case description 2 cases of RA patients were young women, 1 case of RA 13 years, the other a history of 10 months. Two patients admitted to the hospital after exertion have difficulty breathing, dry eyes and dry mouth performance. Laboratory tests were positive anamorphic anemia, rheumatoid factor positive, normal complement, polyclonal increase in γ-globin fragments, IgG, IgM, IgA were higher than normal, increased angiotensin converting enzyme (ACE) , HLA typing showed its phenotype DR_4.1 cases of chest X-ray showed interstitial reticular nodular changes, pulmonary function was limited damage, maximum vital capacity (FVC) decreased, forced expiratory volume per second (FEV_1) Was mild to moderate loss. FEV_1 / FVC normal, total lung capacity normal, functional residual volume (FRC) decreased. Another case of chest X-ray showed double hilar lymph nodes. Pulmonary function including normal dispersion of CO. Two cases by branch