NEJM:复发性多软骨炎性巩膜炎-案例报道

2015-12-24 MedSci MedSci原创

http://www.nejm.org/doi/full/10.1056/NEJMicm1501692

男性,46岁,因出现双侧耳廓肿胀疼痛,并伴有双侧眼球发红、疼痛和畏光而来院就诊。


全身系统检查,发现其右手手腕有疼痛感。此外,双侧耳廓可见明显的红斑和增厚,耳小叶畸形(如图A所示)。

眼科检查发现双侧眼睛结膜、巩膜以及巩膜血管出现严重的充血和炎症现象(如图B所示)。应用去氧肾上腺素滴眼液滴眼未发现充血血管出现发白现象,这与巩膜炎的诊断标准一致。

裂隙灯检查发现双侧视神经盘有水肿和充血的迹象,同时超声检查发现巩膜增厚。实验室检查未见异常。

根据以上临床表现及检查结果,最终会诊医师确诊其患上的是复发性多软骨炎性巩膜炎。
最后,该患者遵医嘱应用糖皮质激素(泼尼松)和睫状肌麻痹剂眼药水进行治疗,治疗效果明显。

原始出处:
Rodríguez-Colón G, Palestine AG. IMAGES IN CLINICAL MEDICINE. Polychondritis with Auricular and Ocular Involvement.  N Engl J Med. 2015 Dec 24;373(26):2562.

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