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復發性多發軟骨炎併鞏膜炎-病例報告及文獻回顧

Relapsing Polychondritis with Scleritis-Report of One Case and Literature Review

摘要


復發性多發軟骨炎為一少見之自體免疫性疾病,主侵犯軟骨及結締組織,其病徵變化多端。本病例為一41歲男性病人因兩眼紅及兩耳反覆性腫痛已兩個月;經檢查為兩眼上鞏膜炎、鞏膜炎及輕微角膜炎,同時兩耳腫脹變形;實驗室檢為抗核抗體陽性,IgA、IgM、IgG升高,紅血球沈降率增加,RA因子陽性,C3、C4約升高;心臟超音波顯示左心室肥大,耳軟骨切片病理檢查為軟骨細胞破壞,軟骨週圍淋巴球及漿液球浸潤。經類固醇及Indomethacin治療後,病情緩解,目前在門診追蹤治療。

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並列摘要


Relapsing polychondritis is an infrequently, episodic systemic disorder characterized by recurrent, wide spread, potentially destructive inflammatory lesions involving cartilaginous structures, the cardiovascular system, and organs of special sense such as eyes and ears. This is a 41-year-old male patient who suffered from both red eyes and swelled ears for 2 months. Ophthalmological examination revealed episcleritis, scleritis and slight keratitis. Laboratory examination showed positive ANA test and RA factor, elevations of IgA, IgM, IgG, C3, C4 and ESR. Echocardiogram revealed left ventricular hypertrophy, pathological changes of biopsy of auricular cartilage showed damaged chondrocyte and inflammatory cell infiltration. The scleritis and swelled ears were well controlled with steroid and eye drops of Indomethacin. Now he is follow up at our clinic.

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