系统性红斑狼疮合并钙质沉着症1例

doi:10.16138/j.1673-6087.2024.06.10

摘要/Abstract

摘要：

皮肤钙质沉着症（calcinosis cutis）是皮肌炎及系统性硬化症的并发症之一，在其他自身免疫性疾病，尤其是系统性红斑狼疮（systemic lupus erythematosus，SLE）中罕见。本文报道了1例确诊SLE 8年的女性患者出现广泛钙质沉着，主要累及四肢，经加用托法替布治疗后有所改善。SLE合并钙质沉着症患者罕见，其发病机制以及治疗方案仍需更多探索和研究，医师需要对此类患者早发现、早诊断、早治疗。

关键词: 系统性红斑狼疮, 钙质沉着症, 并发症, 风湿免疫性疾病

Abstract:

Calcinosis cutis is one of the complications of dermatomyositis and systemic sclerosis, while it is rare in other autoimmune diseases, especially in systemic lupus erythematosus(SLE). This article reports a female patient who had been diagnosed with SLE for 8 years ago, and developed extensive calcification, mainly affecting the limbs. Her condition improved after receiving treatment with tofacitinib. SLE patients complicated with calcinosis are rare, and their pathogenesis and treatment strategies still require doing more exploration and research. Early detection, early diagnosis, and early treatment are essential for the patients.

Key words: Systemic lupus erythematosus, Calcinosis, Complications, Rheumatic and immunologic diseases

中图分类号:

R593.24

刘晏铭, 孙淑玉, 李嵩, 武剑. 系统性红斑狼疮合并钙质沉着症1例[J]. 内科理论与实践, 2024, 19(06): 409-412.

LIU Yanming, SUN Shuyu, LI Song, WU Jian. A case of systemic lupus erythematosus complicated with calcinosis cutis[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(06): 409-412.

图/表 3

参考文献 17

[1]	Boulman N, Slobodin G, Rozenbaum M, et al. Calcinosis in rheumatic diseases[J]. Semin Arthritis Rheum, 2005, 34(6): 805-812.
[2]	Gutierrez A Jr, Wetter DA. Calcinosis cutis in autoimmune connective tissue diseases[J]. Dermatol Ther, 2012, 25(2): 195-206. doi: 10.1111/j.1529-8019.2012.01492.x pmid: 22741938
[3]	Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus[J]. Arthritis Rheumatol, 2019, 71(9): 1400-1412. doi: 10.1002/art.40930
[4]	Dawood NB, Yan KL, Shieh A, et al. Normocalcaemic primary hyperparathyroidism: an update on diagnostic and management challenges[J]. Clin Endocrinol (Oxf), 2020, 93(5): 519-527.
[5]	Bhatia S, Silverberg NB, Don PC, et al. Extensive calcinosis cutis in association with systemic lupus erythematosus[J]. Acta Derm Venereol, 2001, 81(6): 446-447.
[6]	Tristano AG, Villarroel JL, Rodríguez MA, et al. Calcinosis cutis universalis in a patient with systemic lupus erythematosus[J]. Clin Rheumatol, 2006, 25(1): 70-74. pmid: 15902514
[7]	Khudadah M, Jawad A, Pyne D. Calcinosis cutis universalis in a patient with systemic lupus erythematosus[J]. Lupus, 2020, 29(12): 1630-1632.
[8]	Powell RJ. Systemic lupus erythematosus with widespread subcutaneous fat calcification[J]. Proc R Soc Med, 1974, 67(3): 215-217. pmid: 4820822
[9]	Rothe MJ, Grant-Kels JM, Rothfield NF. Extensive calcinosis cutis with systemic lupus erythematosus[J]. Arch Dermatol, 1990, 126(8): 1060-1063. pmid: 2383031
[10]	Kim MS, Choi KC, Kim HS, et al. Calcinosis cutis in systemic lupus erythematosus: a case report and review of the published work[J]. J Dermatol, 2010, 37(9): 815-818.
[11]	Yamamoto T, Furuhata Y, Tsuboi R. Lipomembranous changes and calcification associated with systemic lupus erythematosus[J]. Clin Exp Dermatol, 2007, 32(3): 278-280. pmid: 17263829
[12]	Chevreul K, Brigham KB, Gandré C, et al. The economic burden and health-related quality of life associated with systemic sclerosis in France[J]. Scand J Rheumatol, 2015, 44(3): 238-246. doi: 10.3109/03009742.2014.976653 pmid: 25521915
[13]	Metzger AL, Singer FR, Bluestone R, et al. Failure of disodium etidronate in calcinosis due to dermatomyositis and scleroderma[J]. N Engl J Med, 1974, 291(24):1294-1296.
[14]	Sousa FC, Figueiras M, Parente AR, et al. Dystrophic calcinosis cutis associated with systemic lupus erythematosus[J]. Pan Afr Med J, 2021, 40: 258.
[15]	Elahmar H, Feldman BM, Johnson SR. Management of calcinosis cutis in rheumatic diseases[J]. J Rheumatol, 2022, 49(9):980-989. doi: 10.3899/jrheum.211393 pmid: 35569832
[16]	Balin SJ, Wetter DA, Andersen LK, et al. Calcinosis cutis occurring in association with autoimmune connective tissue disease: the Mayo Clinic experience with 78 patients, 1996-2009[J]. Arch Dermatol, 2012, 148(4):455-462. doi: 10.1001/archdermatol.2011.2052 pmid: 22184719
[17]	Wendel S, Venhoff N, Frye BC, et al. Successful treatment of extensive calcifications and acute pulmonary involvement in dermatomyositis with the Janus-kinase inhibitor tofacitinib[J]. J Autoimmun, 2019, 100: 131-136. doi: S0896-8411(18)30742-X pmid: 30862449