高球蛋白血症性紫癜并发原发性干燥综合征一例

Primary sjogren's syndrome complicated with hyperglobulinemic purpura: a case report

患者,女,47岁。双下肢反复出现瘀点、瘀斑4个月,劳累、不良情绪刺激后加重。实验室检查球蛋白增高、血沉增快、类风湿因子强阳性、轻度贫血、血小板正常;抗SSA、SSB抗体2+,Schirmer试验+,唾液腺ECT:唾液腺自主排泌功能降低。唇腺病理活检符合干燥综合征。结合患者临床表现,诊断为高球蛋白血症性紫癜合并原发性干燥综合征。使用糖皮质激素联合羟氯喹、乙酰半胱氨酸、白芍总苷等口服并规律减量,随访2年病情稳定无复发。

A 47-year-old female presented with leg petechiae and ecchymosis for 4 months.The symptoms were aggravated after fatigue and bad mood stimulation.Laboratory examination showed an increase in globulin levels and erythrocyte sedimentation rate,strong positivity of rheumoid factor,mild anemia,but normality of platelet counting.SSA/SSB and Schirmer test were positive.The function of salivary glands was decreased.The features of biopsy was in accordance with the diagnosis of sjogren s syndrome.The diagnosis of hyperglobulinemic purpura complicated with Sjogren syndrome was made.There was no recurrence of skin lesions after combined therapy with glucocorticoid,gydroxychloroquine,N-acetylcysteine and paeony during 2 years follow-up.