中国麻风皮肤病杂志 ›› 2022, Vol. 38 ›› Issue (8): 530-534.doi: 10.12144/zgmfskin202208530

• 论著 • 上一篇    下一篇

自身免疫性多腺体综合征IIIC+D型一例并文献复习

孔泽琳1,皮庆友1,周桂芝2,李晶1   

  1. 1山东省立第三医院皮肤科，山东济南，250031;
    2山东第一医科大学附属皮肤病医院(山东省皮肤病医院)，山东省皮肤病性病防治研究所，山东济南，250022
  • 出版日期:2022-08-15 发布日期:2022-06-22

Autoimmune polyglandular syndrome type IIIC+D: a case report and literature review

KONG Zelin1, PI Qingyou1, ZHOU Guizhi2, LI Jing1   

  1. 1 Shandong Provincial Third Hospital, Jinan 250031, China; 2 Shandong Provincial Hospital for Skin Diseases ＆ Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University ＆ Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2022-08-15 Published:2022-06-22

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摘要： 报道自身免疫性多腺体综合征IIIC+D一例并对相关文献进行复习。患者，女，48岁。曝光部位淡红色斑片伴瘙痒1个月，关节疼痛5天，查体示双手掌指关节、指间关节见红色斑疹、Gottron丘疹，甲周红斑，双手指间关节略肿胀。患者白癜风病史20余年。实验室检查：抗核抗体弱阳性，24 h尿蛋白定量447.6 mg/24 h；FT3、FT4、TPOAb水平升高、TSH降低，甲状腺彩超考虑桥本氏甲状腺炎，甲亢。患者患有白癜风、系统性红斑狼疮、桥本甲状腺炎、甲状腺功能亢进，符合自身免疫性多腺体综合征IIIC+D型的诊断。系统给予糖皮质激素、硫酸羟氯喹、硫唑嘌呤、白芍总苷、抗甲亢药物治疗后好转。

关键词: 自身免疫性多腺体综合征, 白癜风, 系统性红斑狼疮, 桥本甲状腺炎, 甲状腺功能亢进

Abstract: We report a case of autoimmune polyglandular syndrome type IIIC+D and review the related literature in this paper. A 48-year-old female patient presented with light red patches on the exposed area with itching for 1 month, joint pain for 5 days. She had a 20-year-history of vitiligo.  Physical examination showed light red patches on the exposed area and Gottron papules. Antinuclear antibody was weakly positive, 24-hour urine protein quantification 447.6 mg/24 h. The level of FT3,FT4,TPOAb,TSH were high and TSH was low. Color doppler ultrasonography of thyroid showed hashimoto's thyroiditis, hyperthyroidism. The patient had vitiligo, systemic lupus erythematosus, Hashimoto's thyaroiditis and hyperthyroidism, which was in line with the diagnosis of autoimmune polyglandular syndrome type IIIC+D. The patient was treated with glucocorticoids, hydroxychloroquine sulfate, azathioprine, total glucosides of paeony and anti-hyperthyroidism drugs, and the patient's condition improved.

Key words: autoimmune polyglandular syndromes, vitiligo, systemic lupus erythematosus, Hashimoto's thyroiditis, hyperthyroidism