抗黑素瘤分化相关基因5抗体阳性的皮肌炎与类风湿关节炎重叠综合征合并尺神经、桡神经损伤

Anti-melanomad ifferentiation associated gene 5 antibody-positive dermatomyositis-rheuma arthritis overlap syndrome with ulnar and radial nerve injury:a case report

报告1例抗黑素瘤分化相关基因5(MDA-5)抗体阳性的皮肌炎(DM)与类风湿关节炎(RA)重叠综合征合并尺神经、桡神经损伤。患者男,58岁,因反复胸闷、气喘、发热2年余,加重1周入院。皮肤科检查:双眼睑水肿性红斑,双手指甲皱襞红斑,双手食指伸侧皮肤增厚伴脱屑。肌炎抗体谱:抗MDA-5抗体IgG(+++);肌电图提示尺神经、桡神经损伤;胸部计算机体层成像示两肺胸膜下少许炎症,部分间质性改变。诊断:(1)抗MDA-5抗体阳性的DM与RA重叠综合征;(2)间质性肺炎;(3)尺神经、桡神经损伤。治疗:予免疫球蛋白、糖皮质激素及免疫抑制剂治疗。

A case of anti-melanoma differentiation associated gene 5(MDA-5)antibody-positive dermatomyositis rheumatoid arthritis overlap syndrome with ulnar and radial nerve injury is reported.The patient,a 52-year-old male,was admitted to the hospital due to repeated chest tightness,asthma and fever for more than two years and aggravated for one week.Derma-tological examination:edema erythema of both eyelids,erythema of the nail folds of both hands,thickening of the skin with desquamation on the extended forefinger of both hands.Myositis antibody spectrum:anti-MDA-5 antibody IgG(+++).Electromyo-graphy indicated injury to the ulnar and radial nerves.Chest CT showed slight inflammation under the pleura of both lungs,with some interstitial changes.The patient was diagnosed with MDA-5 positive dermatomyositis rheumatoid arthritis overlap syndrome with ulnar and radial nerve injury.Methylprednisolone with immunosuppressive was administered.