皮肌炎重叠系统性硬化症合并横纹肌溶解症1例并文献复习

A case report and literature review on polymyositis and progressive systemic sclerosis associated with rhabdomyolysis

目的:提高对重叠综合症继发横纹肌溶解症的认识。方法:报告1例罕见的重叠综合症患者继发横纹肌溶解症病例,并复习相关文献。结果:患者为43岁女性,以皮疹、肌无力2年半,肢端遇冷变色伴皮肤紧硬1年半为主要临床表现,肌酸激酶极度升高,血肌红蛋白、尿肌红蛋白明显高于正常,考虑重叠综合征继发横纹肌溶解症,经血液净化、免疫抑制等治疗临床症状及实验室指标改善。结论:重叠综合征继发横纹肌溶解症临床罕见,当出现急性肾功能衰竭时,与系统性硬化症出现急性肾危象不易鉴别,容易漏诊。

Objective： To improve the understanding of overlap syndrome associated with rhabdomyolysis.Methods： A case of overlap syndrome complicated with rhabdomyolysis was reported and the related literatures were reviewed.Results： A 43-year-old woman presented with clinically skin rash,myasthenia weakness,Raynaud＇s phenomenon and hard skin.Laboratory investigations showed increased blood creatinine kinase（CK）,serum and urine myoglobin.After haemodialysis and immunosuppressant treatment,her condition gradually improved.Conclusion： Overlap syndrome associated with rhabdomyolysis is rare,and systemic sclerosis could also have renal crisis,which could lead to miss diagnosis of rhabdomyolysis.