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目的分析Rhupus综合征的发病机制及临床特点。方法对1例类风湿关节炎(RA)重叠系统性红斑狼疮(SLE)的Rhupus综合征患者的病例资料进行分析,复习相关文献并总结临床最新研究进展。结果 1例女性,有月经紊乱史,以RA为首发表现,经17年的RA病程才出现SLE特征性表现,就诊时关节症状严重并出现关节畸形,血沉(ESR)、C-反应蛋白(CRP)及类风湿因子(RF)水平均明显升高,抗Sm抗体和抗双链DNA抗体阳性,补体C3、C4水平明显降低,累及血液系统及肾脏,分别表现为自身免疫性溶血性贫血及肾病综合征,联合应用泼尼松、羟氯喹治疗后病情好转。结论 Rhupus综合征患者的关节症状严重,致畸率高,可累及血液、肾脏及脑等内脏系统,对高危患者应规律随访,监测临床及实验指标,早期合理治疗,可明显改善患者预后。
Objective To analyze the pathogenesis and clinical features of Rhupus syndrome. Methods A case of Rheumatoid arthritis (RA) with systemic lupus erythematosus (SLE) in patients with Rhupus syndrome was analyzed. The related literatures were reviewed and the latest clinical research was summarized. Results A woman with a history of menstrual disorders showed RA as the first manifestation. The characteristic manifestations of SLE appeared only after 17 years of RA. The symptoms of her joints were severe and the symptoms such as joint deformity, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) ) And rheumatoid factor (RF) were significantly increased, anti-Sm antibody and anti-double-stranded DNA antibody positive, complement C3, C4 levels were significantly lower, involving the blood system and the kidneys, were manifested as autoimmune hemolytic anemia and renal disease Syndrome, combined with prednisone, hydroxychloroquine after treatment improved. Conclusion Rhupus syndrome patients with severe joint symptoms, high teratogenicity may affect the blood, kidneys and brain and other visceral systems, regular follow-up of high-risk patients, monitoring of clinical and experimental indicators, early rational treatment can significantly improve the prognosis of patients.