NEJM:萎缩性舌炎-病例报道

2019-10-17 xing.T MedSci原创

该患者开始每周一次肌肉内注射维生素B12的治疗。治疗2周后,患者的口腔症状减轻,并且在1个月随访时,萎缩性舌炎已经恢复。

患者为一名64岁的男性,因舌头疼痛、光滑、发红而到口腔科就诊,在六个月前出现过唇部灼热感。

体格检查发现舌头萎缩,红斑,舌乳头缺失(如图A所示)。神经系统检查未发现异常。实验室检查显示血红蛋白水平为13.7g/L(正常范围,从13.1至16.6),平均红细胞体积为101.5 fl(参考范围,从83.0至95.5)。血清维生素B12含量低于37 pmol/L(50 pg/mL;参考范围为135至675 pmol/L [180至910 pg/mL])。血清叶酸水平正常。抗内源性因子自身抗体的检测结果为阳性,滴度为60 U/mm,抗壁细胞自身抗体的滴度为16 U/ml(两个滴度在20 U/ml以内均为阴性)。该患者被诊断为恶性贫血。



该患者开始每周一次肌肉内注射维生素B12的治疗。治疗2周后,患者的口腔症状减轻,并且在1个月随访时,萎缩性舌炎已经恢复(如图B所示)。

患者的维生素B12水平升高,并且他继续接受每月注射维生素B12。 
 
原始出处:

Andrew N. Robinson,et al.Atrophic Glossitis.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1902490

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    2020-07-01 chendoc252
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    2019-10-17 旺医

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