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NEJM：牙龈上长出了草莓-病例报道

2017-11-23 xing.T MedSci原创

草莓样牙龈炎血管炎性肉芽肿牙龈增生
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草莓样牙龈炎是肉芽肿性血管炎的一种罕见表现，其临床表现高度提示为该病。该患者开始服用泼尼松龙和环磷酰胺治疗，但后续失访，无法知晓其治疗结局。

患者为一名42岁的女性，因快速进展的伴有疼痛的牙龈增生6周而到口腔门诊就诊。该患者有复发性鼻出血，在过去的4周里，她的脸上出现了三个坏死性溃疡。



口腔检查发现牙龈增生与典型的“草莓样牙龈炎”颗粒及出血表现。实验室检查结果显示胞质染色图片中抗中性粒细胞胞浆抗体（C-ANCA）滴度升高，并且酶联免疫吸附试验检查发现抗-蛋白酶3抗体阳性。血清肌酐水平和尿检结果正常。头部和胸部的计算机断层扫描显示正常的鼻窦和多发肺结节。基于这些临床和实验室检查结果诊断为血管炎性肉芽肿。

草莓样牙龈炎是肉芽肿性血管炎的一种罕见表现，其临床表现高度提示为该病。该患者开始服用泼尼松龙和环磷酰胺治疗，但后续失访，无法知晓其治疗结局。

原始出处：

Maryam Ghiasi,et al. Strawberry Gingivitis in Granulomatosis with Polyangiitis.N Engl J Med 2017; http://www.nejm.org/doi/full/10.1056/NEJMicm1706987

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    2017-11-26 半夏微凉

    学习了谢谢分享

    0

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    2017-11-24 wgsun

    #草莓#

    0

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    2017-11-24 1e10c84am36(暂无匿称)

    好文竞大家共同分享

    0

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    2017-11-24 陈方郑

    西红柿就是就是惊声尖叫手机十几集

    0

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    2017-11-24 187清风

    谢谢分享!

    0

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    2017-11-23 杏林一叶

    第一次看到.谢谢分享!

    0

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    2017-11-23 老坛

    涨知事啦

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=264496, encodeId=c327264496ae, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Nov 26 12:11:02 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584998, encodeId=fe581584998c2, content=<a href='/topic/show?id=60ae8e21987' target=_blank style='color:#2F92EE;'>#草莓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87219, encryptionId=60ae8e21987, topicName=草莓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=efad17095399, createdName=wgsun, createdTime=Fri Nov 24 22:49:00 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263918, encodeId=28bd2639188d, content=好文竞大家共同分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, 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=Fri Nov 24 10:15:35 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263914, encodeId=71e626391403, content=西红柿就是就是惊声尖叫手机十几集, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83erHmiaPStHsBjHGm3Y4ZHHanFXRDgAiaEiabOGdC4Q6KfAYrmmuicVyBk7YMJOMXTuQnIpZqReTiceibjdg/132, createdBy=2ab92087896, createdName=陈方郑, createdTime=Fri Nov 24 09:59:46 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263855, encodeId=8a9e26385508, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cb571956164, createdName=187清风, createdTime=Fri Nov 24 07:48:38 CST 2017, time=2017-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263661, encodeId=d4572636612c, content=第一次看到.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dbbe2184942, createdName=杏林一叶, createdTime=Thu Nov 23 16:17:09 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263579, encodeId=0cf92635e9e4, content=涨知事啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIVRqj4iarZPMruOs51Vuiba4Sja9gGBQetbhlHEOYUEScQ2BQ4wSaItfuuJU7Z3U8UysINtNHSEGrw/0, createdBy=37592204366, createdName=老坛, createdTime=Thu Nov 23 10:18:52 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263549, encodeId=b372263549c9, content=学习一下知识了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu Nov 23 08:37:16 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263547, encodeId=a92126354ef2, content=好文章大家共同分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Thu Nov 23 08:23:26 CST 2017, time=2017-11-23, status=1, ipAttribution=)]
    2017-11-23 flysky120

    学习一下知识了.谢谢

    0

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    2017-11-23 1e10c84am36(暂无匿称)

    好文章大家共同分享

    0