以水肿为主要表现的系统性硬化症1例

Edema as a main manifestation of systemic sclerosis： a case report

笔者成功诊断1例76岁男性系统性硬化症患者。本患者主要表现为水肿，发病初期一直未明确诊断，对症支持治疗仅暂时缓解病情。水肿加重后查血清相关自身抗体示抗核抗体阳性，结合皮肤活检病理明确诊断为系统性硬化症。根据文献报道和笔者的临床经验，系统性硬化症临床表现复杂多样，缺乏特异性，早期诊断困难。对于临床上难以解释的水肿，应考虑本病的可能，重视患者皮肤的改变及血清相关自身抗体的检查，及早做出正确诊断。

We reported a successful diagnosis of a 76-year-old male patient with systemic sclerosis. His main manifestation was edema, and the diagnosis was indefinite at the early stage. Symptomatic and supportive treatments were merely useful for temporary remission of the symptoms. Testing for serum related auto-antibodies showed that anti-nuclear antibody was positive after the aggravation of edema. Ultimately, the diagnosis of systemic sclerosis was established after skin biopsy. According to literature and our clinical experience, the clinical manifestations of systemic sclerosis were complicated and lack of specificity, so it was hard to diagnose at its early stage. We should take systemic sclerosis into consideration when we meet intractable cases with edema. More attention should be paid to skin lesion and serum related auto-antibodies testing in order to make the correct diagnosis of this disease as early as possible.