BMC Oral Health:来源不明的骨质溶解——病例报道

2016-01-13 MedSci MedSci原创

结节病是一种肉芽肿性疾病,可影响全身任何一个器官。最常累及的部位为肺部。但是,个别情况下,结节病可累及到骨组织。据已有文献描述显示,肿胀或瘘管是骨病变的首要症状。该病例报道中结节病累及患者双侧下颌角区域,同时累及了全身多个器官。

结节病是一种肉芽肿性疾病,可影响全身任何一个器官。最常累及的部位为肺部。但是,个别情况下,结节病可累及到骨组织。据已有文献描述显示,肿胀或瘘管是骨病变的首要症状。该病例报道中结节病累及患者双侧下颌角区域,同时累及了全身多个器官。

患者为一名74岁的欧洲女性,无结节病史,下颌角区域疼痛。没有进一步的临床症状。骨活检后影像学检查显示,病损区域出现非干酪性肉芽肿,符合骨结节病的病理表现。进一步检查确认多器官受累——肺部、胸内淋巴结以及中枢神经系统。

本病例报告显示,严重疾病若未出现全身性的临床表现,则极易误诊。此外,需要书写准确的病历并进行正确的检查,以获得早期诊断,这往往需要一个跨学科的方法。

原始出处:

Matthias Guido Wiesli, Katrin E. Hostettler, Michael Tamm,  Claude Jaquiéry. Osteolysis of unknown origin: a case report .BMC Oral Health. 2015; 15: 168. Published online 2015 Dec 30. doi:  10.1186/s12903-015-0158-8

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    2016-09-13 1e10c84am36(暂无匿称)

    好文章,还会关注

    0

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    2016-09-13 ylzr123

    好文,赞一个,深入学习。

    0

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    2016-08-15 小几洁
  4. 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createdName=ylzr123, createdTime=Tue Sep 13 10:18:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2020184, encodeId=341d2020184f9, content=<a href='/topic/show?id=1584134451c' target=_blank style='color:#2F92EE;'>#Oral#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13445, encryptionId=1584134451c, topicName=Oral)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpeueeYB1kem1yfEZrSYKBdZBoqac9USf0RxIgRICBIyDn4licyiaiakNnobeCDVpvwqaWgwTNeLRHA/132, createdBy=bb5e2500127, createdName=小几洁, createdTime=Mon Aug 15 13:11:00 CST 2016, time=2016-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861047, encodeId=9370186104e27, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Jun 06 14:11:00 CST 2016, time=2016-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974675, encodeId=2fbd19e46754e, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Fri Mar 25 00:11:00 CST 2016, time=2016-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1592306, encodeId=17f5159230645, content=<a href='/topic/show?id=6dc2101853ed' target=_blank style='color:#2F92EE;'>#骨质#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101853, encryptionId=6dc2101853ed, topicName=骨质)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1d018108513, createdName=Eleven17, createdTime=Fri Jan 15 07:11:00 CST 2016, time=2016-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621568, encodeId=496c1621568e9, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Jan 15 07:11:00 CST 2016, time=2016-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57213, encodeId=d5815e213c6, content=还真的注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Jan 14 12:21:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57182, encodeId=d0895e1823d, content=赞\(≧▽≦)/, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Thu Jan 14 09:27:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57174, encodeId=9c825e17488, content=活检太重要了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Thu Jan 14 08:15:00 CST 2016, time=2016-01-14, status=1, ipAttribution=)]
    2016-06-06 智慧医人
  5. [GetPortalCommentsPageByObjectIdResponse(id=124739, encodeId=739f124e39a8, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:03:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124446, encodeId=c17b124446a4, content=好文,赞一个,深入学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:18:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2020184, encodeId=341d2020184f9, content=<a href='/topic/show?id=1584134451c' target=_blank style='color:#2F92EE;'>#Oral#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13445, encryptionId=1584134451c, topicName=Oral)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpeueeYB1kem1yfEZrSYKBdZBoqac9USf0RxIgRICBIyDn4licyiaiakNnobeCDVpvwqaWgwTNeLRHA/132, createdBy=bb5e2500127, createdName=小几洁, createdTime=Mon Aug 15 13:11:00 CST 2016, time=2016-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861047, encodeId=9370186104e27, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon Jun 06 14:11:00 CST 2016, time=2016-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974675, encodeId=2fbd19e46754e, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Fri Mar 25 00:11:00 CST 2016, time=2016-03-25, status=1, ipAttribution=), 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createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Jan 15 07:11:00 CST 2016, time=2016-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57213, encodeId=d5815e213c6, content=还真的注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Jan 14 12:21:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57182, encodeId=d0895e1823d, content=赞\(≧▽≦)/, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Thu Jan 14 09:27:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57174, encodeId=9c825e17488, content=活检太重要了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Thu Jan 14 08:15:00 CST 2016, time=2016-01-14, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=124739, encodeId=739f124e39a8, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:03:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124446, encodeId=c17b124446a4, content=好文,赞一个,深入学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, 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createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Jan 15 07:11:00 CST 2016, time=2016-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57213, encodeId=d5815e213c6, content=还真的注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Jan 14 12:21:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57182, encodeId=d0895e1823d, content=赞\(≧▽≦)/, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHfSLw3PzIKiaSnTBUuAtRkrrxWpibukl35iciaGtBq4LYQv4ian1tPC3IdmzWI2dZ3cDC8wUg5CnBxlJ/0, createdBy=33a51675735, createdName=jiangxianchen, createdTime=Thu Jan 14 09:27:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57174, encodeId=9c825e17488, content=活检太重要了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Thu Jan 14 08:15:00 CST 2016, time=2016-01-14, status=1, ipAttribution=)]
    2016-01-15 Eleven17
  7. [GetPortalCommentsPageByObjectIdResponse(id=124739, encodeId=739f124e39a8, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:03:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124446, encodeId=c17b124446a4, content=好文,赞一个,深入学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, 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  8. 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createdName=jiangxianchen, createdTime=Thu Jan 14 09:27:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57174, encodeId=9c825e17488, content=活检太重要了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Thu Jan 14 08:15:00 CST 2016, time=2016-01-14, status=1, ipAttribution=)]
    2016-01-14 xiaotaiyang1

    还真的注意

    0

  9. 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createdName=jiangxianchen, createdTime=Thu Jan 14 09:27:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57174, encodeId=9c825e17488, content=活检太重要了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Thu Jan 14 08:15:00 CST 2016, time=2016-01-14, status=1, ipAttribution=)]
    2016-01-14 jiangxianchen

    赞\(≧▽≦)/

    0

  10. 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createdName=jiangxianchen, createdTime=Thu Jan 14 09:27:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=57174, encodeId=9c825e17488, content=活检太重要了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Thu Jan 14 08:15:00 CST 2016, time=2016-01-14, status=1, ipAttribution=)]
    2016-01-14 卡莲

    活检太重要了

    0