诊治系统性硬皮病导致的肝损害1例

Systemic Seleroderma Disease-related Hepatic Injury

目的研究硬皮病(Systemic Seleroderma)导致肝损害至肝硬化的临床特征及其诊断和治疗。方法对1例硬皮病导致肝损害患者的病史、临床表现、实验室检查、诊断治疗经过以及近期疗效进行回顾性分析。结果患者为老年女性,临床表现为乏力、腹胀,有血管炎、截趾手术等病史,血IgG、球蛋白升高,ESR增快,血ANA1:320阳性,肝脏病理特点符合结缔组织病所致的小血管炎表现。经小剂量甲泼尼松龙治疗后,临床症状和实验室检查指标明显好转,近期疗效显著。结论对于硬皮病患者肝功异常的鉴别诊断应该想到硬皮病导致肝损害的可能,对于肝功能损害明显、常规保肝治疗无效的患者可应用小剂量糖皮质激素治疗。

Objective To present the clinical features and management of a patiant with Systemic Seleroderma （SSc） disease-related hepatic injury. Methods Data of one case with SSc-related hepatic injury, including the case history, clinical manifestations, laboratory findings, treatment and short-term effect were reviewed retrospectively. Results The patient was a-old-aged woman who presented with symptoms of fatigue, anorexia, ascitic. ＂blood vessel＂, amputaion. Laboratory findings showed elevated serumtransaminases, IgG and globulin levels,accelerated erythrocyte sedimentation rate,eosinophilia and high titer of antinuclear antibodies （1 ： 320）. Liver biopsy showed the features consistent with connective tissue diseases-related !bolyangitis. Both symptoms and laboratorytests improved significamtly after treatment with low-dose prednisone. Conclusion UCTD-related hepatic injury should be considered inthe differential diagnosis of connective tissue diseases with abnormal liver function tests. Low-dose prednisone was effective to improveboth symptoms and laboratory tests.