CAJ | 학술논문

报告1例女性瘤型麻风.患者女,39岁,因多关节痛,面部及上肢酱红色丘疹,斑块半年就诊,伴有光敏,发热及乏力.实验室检查:尿蛋白强阳性、血红蛋白 97g/L,血小板51 × 109/L,补体C3为560 mg/L(850～1930 mg/L)、C4为103 mg/L( 120～360 mg/L)、ANA 1:160阳性.符合系统性红斑狼疮诊断条件,给予泼尼松50 mg/d、沙利度按100 mg/d及羟氯喹200 mg/d,治疗后系统症状改善,但皮损进行性加重,两年后逐渐出现上腭及鼻中隔穿孔等病变.最终经组织病理检查及抗酸染色确诊为瘤型麻风.提示瘤型麻风可以出现多系统损害,自身抗体阳性,必须警惕误诊为风湿性疾病.
보고1례녀성류형마풍.환자녀,39세,인다관절통,면부급상지장홍색구진,반괴반년취진,반유광민,발열급핍력.실험실검사:뇨단백강양성、혈홍단백 97g/L,혈소판51 × 109/L,보체C3위560 mg/L(850～1930 mg/L)、C4위103 mg/L( 120～360 mg/L)、ANA 1:160양성.부합계통성홍반랑창진단조건,급여발니송50 mg/d、사리도안100 mg/d급간록규200 mg/d,치료후계통증상개선,단피손진행성가중,량년후축점출현상악급비중격천공등병변.최종경조직병리검사급항산염색학진위류형마풍.제시류형마풍가이출현다계통손해,자신항체양성,필수경척오진위풍습성질병.
A case of lepromatous leprosy is reported.A 39 -year- old female presented with symmetric polyarthritis and jelly-colored papules on the upper limbs and face accompanied by photosensitivity,fever and fatigue for half a year.The lesions were itchy and worsened after sun exposure.Laboratory examination revealed that the urinary protein was strongly positive,hemoglobin level 97 g/L,platelet count 51 x 109/L,serum complement 3 (C3) level 560 mg/L (reference value: 850-1930 mg/L),C4 level 103 mg/L (reference value: 120-360 mg/L),antinuclear antibody titer 1: 160.Based on these findings,she was diagnosed with systemic lupus erylhematosus,and trealed with oral prednisone 50 mg,thalidomide 100 mg,and hydroxychloroquine 200 mg per day.Subscquently,systemic symptom improved,whereas the skin lesions were progressively exacerbated with the development of nasal septum and palate perforation 2 years: after the treatment.Finally,histopathological examination and acid fast stain confirmed a diagnosis of lepromatous leprosy.This case implies that lepromatous leprosy may manifest as multisystemic damage with the presence of autoantibodies,and dermatologists should be on guard against the misdiagnosis of lepromatous leprosy as rheumatic disease.