强直性脊柱炎合并白塞病继发抗磷脂综合征一例并文献复习

Coexistence of ankylosing spondylitis and Behçet's disease associated with antiphospholipid syndrome: a case report and literature review

目的探讨AS合并白塞病继发APS的临床特点及诊断。方法分析1例AS合并白塞病继发APS患者的病历资料,并进行文献复习。结果该病例为26岁男性患者,炎性下腰痛,双侧骶髂关节炎Ⅱ级,诊断为AS。患者因反复口腔溃疡、虹膜炎、血管病变、针刺试验阳性,诊断为白塞病。患者反复下肢深静脉血栓,多次实验室检查抗磷脂抗体高滴度阳性,诊断为白塞病继发的APS。经糖皮质激素、复方环磷酰胺片、阿达木单抗注射液、达比加群酯胶囊治疗后病情好转。结论AS合并白塞病,白塞病合并APS,AS合并APS,均有一些病例报道,三者之间关系复杂,需提高对三者的关注,以减少漏诊或误诊。

Objective To explore the clinical features and diagnosis of coexistence of ankylosing spondylitis(AS)and Behçet's disease associated with antiphospholipid syndrome(APS).Methods We analyzed a case of coexistence of ankylosing spondylitis and Behçet's disease associated with APS in Seventh Medical Center of Chinese PLA General Hospital in 2016,and the related literature were reviewed.Results A 26-year-old male patient suffered from inflammatory low back pain,arthralgia and iritis.A His CT imaging revealed bilateral gradeⅡof bilateral sacroiliac arthritis.He was diagnosed as AS.He also had recurrent oral ulceration,iritis,vascular disorders and positive acupuncture pathergy test.He was diagnosed as Behçet's disease.He suffered from recurrentpeated venous thrombosis.Laboratory tests revealed positive antiphospholipid antibodies.He was diagnosed as secondary APS complicated with Behçet's disease.After he was treated with of glucocorticosteroid,cyclophosphamide,adalimumab and dabigatran,his condition improved significantly.Conclusion There are some cases reported of AS with Behçet's disease,or Behçet's disease with APS,or AS with APS.The relationship between them is complex.The possibility of coexistence of AS and Behçet's disease and APS should not be ignored,in order to avoid misdiagnosis.