12岁女孩反复腹痛、呕吐伴三酰甘油升高、抗核抗体阳性

患儿为12岁2个月的青少年女性,反复腹痛、呕吐2年余,关节痛3个月,诊断为复发性急性胰腺炎,多次入院治疗,胰腺炎原因不明.实验室检查发现空腹血清三酰甘油多次显著升高,免疫球蛋白升高、抗核抗体阳性,予对症支持治疗后症状好转.3个月前患儿出现四肢关节肿痛伴活动障碍,检查发现蛋白尿、血尿,抗双链DNA抗体阳性,进一步肾脏穿刺检查,病理及冷冻切片免疫荧光提示弥漫性狼疮性肾炎(Ⅳ型).最终诊断为系统性红斑狼疮、狼疮性肾炎Ⅳ型、复发性急性胰腺炎.胰腺炎高度可疑与系统性红斑狼疮有关.予硫酸羟氯喹、甲泼尼龙琥珀酸钠及环磷酰胺治疗,四肢关节肿痛症状改善.后改为醋酸泼尼松片口服,定期予以环磷酰胺冲击治疗及贝利优单...

Full description

Saved in:
Bibliographic Details
Published in中国当代儿科杂志 Vol. 24; no. 8; pp. 917 - 922
Main Authors 方优红, 林海华, 楼金玕, 陈洁
Format Journal Article
LanguageChinese
Published 浙江大学医学院附属儿童医院消化内科/国家儿童健康与疾病临床医学研究中心,浙江杭州 310052 01.08.2022
Subjects
狼疮性肾炎
系统性红斑狼疮
儿童
复发性急性胰腺炎
系统性红斑狼疮相关性胰腺炎
Online AccessGet full text
ISSN1008-8830
DOI10.7499/j.issn.1008-8830.2203006

Cover

Abstract 患儿为12岁2个月的青少年女性,反复腹痛、呕吐2年余,关节痛3个月,诊断为复发性急性胰腺炎,多次入院治疗,胰腺炎原因不明.实验室检查发现空腹血清三酰甘油多次显著升高,免疫球蛋白升高、抗核抗体阳性,予对症支持治疗后症状好转.3个月前患儿出现四肢关节肿痛伴活动障碍,检查发现蛋白尿、血尿,抗双链DNA抗体阳性,进一步肾脏穿刺检查,病理及冷冻切片免疫荧光提示弥漫性狼疮性肾炎(Ⅳ型).最终诊断为系统性红斑狼疮、狼疮性肾炎Ⅳ型、复发性急性胰腺炎.胰腺炎高度可疑与系统性红斑狼疮有关.予硫酸羟氯喹、甲泼尼龙琥珀酸钠及环磷酰胺治疗,四肢关节肿痛症状改善.后改为醋酸泼尼松片口服,定期予以环磷酰胺冲击治疗及贝利优单克隆抗体泵注等治疗,目前关节疼痛好转,仍有蛋白尿及血尿.临床上需要警惕以胰腺炎为首发表现的系统性红斑狼疮,对不明原因胰腺炎需进行相关免疫学指标检查,密切监测其他系统的症状,以免延误诊断.
AbstractList 患儿为12岁2个月的青少年女性,反复腹痛、呕吐2年余,关节痛3个月,诊断为复发性急性胰腺炎,多次入院治疗,胰腺炎原因不明.实验室检查发现空腹血清三酰甘油多次显著升高,免疫球蛋白升高、抗核抗体阳性,予对症支持治疗后症状好转.3个月前患儿出现四肢关节肿痛伴活动障碍,检查发现蛋白尿、血尿,抗双链DNA抗体阳性,进一步肾脏穿刺检查,病理及冷冻切片免疫荧光提示弥漫性狼疮性肾炎(Ⅳ型).最终诊断为系统性红斑狼疮、狼疮性肾炎Ⅳ型、复发性急性胰腺炎.胰腺炎高度可疑与系统性红斑狼疮有关.予硫酸羟氯喹、甲泼尼龙琥珀酸钠及环磷酰胺治疗,四肢关节肿痛症状改善.后改为醋酸泼尼松片口服,定期予以环磷酰胺冲击治疗及贝利优单克隆抗体泵注等治疗,目前关节疼痛好转,仍有蛋白尿及血尿.临床上需要警惕以胰腺炎为首发表现的系统性红斑狼疮,对不明原因胰腺炎需进行相关免疫学指标检查,密切监测其他系统的症状,以免延误诊断.
Author 陈洁
方优红
林海华
楼金玕
AuthorAffiliation 浙江大学医学院附属儿童医院消化内科/国家儿童健康与疾病临床医学研究中心,浙江杭州 310052
AuthorAffiliation_xml – name: 浙江大学医学院附属儿童医院消化内科/国家儿童健康与疾病临床医学研究中心,浙江杭州 310052
Author_FL LIN Hai-Hua
FANG You-Hong
LOU Jin-Gan
CHEN Jie
Author_FL_xml – sequence: 1
  fullname: FANG You-Hong
– sequence: 2
  fullname: LIN Hai-Hua
– sequence: 3
  fullname: LOU Jin-Gan
– sequence: 4
  fullname: CHEN Jie
Author_xml – sequence: 1
  fullname: 方优红
– sequence: 2
  fullname: 林海华
– sequence: 3
  fullname: 楼金玕
– sequence: 4
  fullname: 陈洁
BookMark eNo9j81Kw0AcxPdQwbb6Dl49JP73I9vNUYqfFLzouSTZTTFKCi4i9NQeiigUW1Qa8OJBERFBWg8t6NPYTc1bGFC8zMD8YIYpoULcjBVCKxjsCnPdtcg-1Dq2MYCwhKBgEwIUgBdQ8T9bRCWtIwBHMJcW0S4mZtQxj2Pz-myueuah992dzod3X-2OGdyafn_28T6bXGTdt_lNko6mpneevSQ5TS-H6f0k19nndZaM0_bTEloIvWOtlv-8jA42N_ar21Ztb2unul6zNAZGrUAGkhEsfY87WCpBGICihAjBA-4z4WNXMeqFXElfVLhPWVhhlDuKORAwh9EyWv3tPfPi0Isb9ah5ehLni_VWQ0p11GoRyI8LwJT-AM6Vasw
ContentType Journal Article
Copyright Copyright © Wanfang Data Co. Ltd. All Rights Reserved.
Copyright_xml – notice: Copyright © Wanfang Data Co. Ltd. All Rights Reserved.
DBID 2B.
4A8
92I
93N
PSX
TCJ
DOI 10.7499/j.issn.1008-8830.2203006
DatabaseName Wanfang Data Journals - Hong Kong
WANFANG Data Centre
Wanfang Data Journals
万方数据期刊 - 香港版
China Online Journals (COJ)
China Online Journals (COJ)
DatabaseTitleList
DeliveryMethod fulltext_linktorsrc
DocumentTitle_FL Recurrent abdominal pain and vomiting with elevated triglyceride and positive antinuclear antibody in a girl aged 12 years
EndPage 922
ExternalDocumentID zgddekzz202208013
GroupedDBID ---
-05
2B.
4A8
92F
92I
93N
ABJNI
ACGFS
ALMA_UNASSIGNED_HOLDINGS
CCEZO
CIEJG
CW9
EMOBN
F5P
PSX
RPM
TCJ
TGQ
U1G
U5O
ID FETCH-LOGICAL-s1043-cdcd421dba651de82400e322886c6b48b19e43af6edb876b34f74365e450c4543
ISSN 1008-8830
IngestDate Thu May 29 03:59:54 EDT 2025
IsPeerReviewed false
IsScholarly true
Issue 8
Keywords 狼疮性肾炎
系统性红斑狼疮
儿童
复发性急性胰腺炎
系统性红斑狼疮相关性胰腺炎
Language Chinese
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-s1043-cdcd421dba651de82400e322886c6b48b19e43af6edb876b34f74365e450c4543
PageCount 6
ParticipantIDs wanfang_journals_zgddekzz202208013
PublicationCentury 2000
PublicationDate 2022-08-01
PublicationDateYYYYMMDD 2022-08-01
PublicationDate_xml – month: 08
  year: 2022
  text: 2022-08-01
  day: 01
PublicationDecade 2020
PublicationTitle 中国当代儿科杂志
PublicationTitle_FL Chinese Journal of Contemporary Pediatrics
PublicationYear 2022
Publisher 浙江大学医学院附属儿童医院消化内科/国家儿童健康与疾病临床医学研究中心,浙江杭州 310052
Publisher_xml – name: 浙江大学医学院附属儿童医院消化内科/国家儿童健康与疾病临床医学研究中心,浙江杭州 310052
SSID ssj0058493
ssib051368748
ssib001103687
ssib046626328
ssib002262955
Score 2.3451228
Snippet 患儿为12岁2个月的青少年女性,反复腹痛、呕吐2年余,关节痛3个月,诊断为复发性急性胰腺炎,多次入院治疗,胰腺炎原因不明.实验室检查发现空腹血清三酰甘油多次显著升高,免疫球...
SourceID wanfang
SourceType Aggregation Database
StartPage 917
Title 12岁女孩反复腹痛、呕吐伴三酰甘油升高、抗核抗体阳性
URI https://d.wanfangdata.com.cn/periodical/zgddekzz202208013
Volume 24
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVAQN
  databaseName: PubMed Central
  issn: 1008-8830
  databaseCode: RPM
  dateStart: 20160101
  customDbUrl:
  isFulltext: true
  dateEnd: 99991231
  titleUrlDefault: https://www.ncbi.nlm.nih.gov/pmc/
  omitProxy: true
  ssIdentifier: ssj0058493
  providerName: National Library of Medicine
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnR1NaxQxdCj14kUUFb8pYk6ydSeTySTHzO4spaCnFnorMzuzFYQK2l721B6KKBQrKi146UEREUFaDy3or7Gztf_C916yu9O6QhWW4ZH3Xt5XNnnJJBPPu9Mu6qnMUjx-FnRqAtpELU11XgsCn_NIiraiW0vuP5BTs2J6LpwbG9-u7FpaXsom292R50r-J6pQBnHFU7L_ENlBpVAAMMQXnhBheJ4qxj5nSchiDukgAgbggIAmMxoB1WKqSSWCAMUU0AAqYhp-MUsC3Opg2bXPdEgAbn5giWBxg8WCAGAELk3sdWIXTCuWSJQeW1lNpiKkMTGhBjVLpgyKA8DUsaphCdTcZDpALmBB5SVymaiaMzsFDBkCOscEOEZAxcyQ1QrgFupmIrQFqtKgknVRi-nBgEsYSVqTiahsxGLDDD9GkjilY-CP-hYmVRJ0eIPcYiVGgGf2Nk9LAmYB0voJk_bqGgtMz_s7_Oy_wskCDgQgGC0XORP1gypJjQbaPCwhIYb3pQky2Ef9jzklRnWH7AMukCVJR0JpK0JipAeu5K1jrjcJsoyu3HcAuDOO-k0noRYDghLX8rByQsXCEUODGGFahC0GmhoCmoRWmgKIVgF0EaP8RrF3ZCAxuYtvmMLKEjd-baqmlHtb58Zoe87e9UWqMuBqe_LX5W7annE_mRZEMK2ntAAFTA4ETHIOQ1z9xJfYKbfrLsCw_6jbxcYAcyq8FvsMdF28fmI9EJLnQKrqgojkenjSW0j82NNwgh_6SC0G7zkh-9f2CJBTye41RH3v_U1bOl242EkXFyqJ8Mx575ybwU4Y2x1d8Ma6Dy960z4vd1bLD7vll0_ly_Xy_fqvtf3DzXc_V1bLV2_LjY2D798O9p4frX09fLPV29kv158dfd4CbO_FZm97D54HP14fbe32Vj5e8mZbyUxjquauaak99XHvTjtv54L7eZbK0M8LhbvSC8gTlJJtmQmV-boQQdqRRZ5B7pUFogPTFhkWIqy3RSiCy9744uPF4oo3IYI88zuR70slRCYk3rcSFBw4UpWqnF_1bjvb5103_HT-j1BdOw3Rde_s8I9-wxtferJc3ITpxVJ2iyL8G1ot0jE
linkProvider National Library of Medicine
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=12%E5%B2%81%E5%A5%B3%E5%AD%A9%E5%8F%8D%E5%A4%8D%E8%85%B9%E7%97%9B%E3%80%81%E5%91%95%E5%90%90%E4%BC%B4%E4%B8%89%E9%85%B0%E7%94%98%E6%B2%B9%E5%8D%87%E9%AB%98%E3%80%81%E6%8A%97%E6%A0%B8%E6%8A%97%E4%BD%93%E9%98%B3%E6%80%A7&rft.jtitle=%E4%B8%AD%E5%9B%BD%E5%BD%93%E4%BB%A3%E5%84%BF%E7%A7%91%E6%9D%82%E5%BF%97&rft.au=%E6%96%B9%E4%BC%98%E7%BA%A2&rft.au=%E6%9E%97%E6%B5%B7%E5%8D%8E&rft.au=%E6%A5%BC%E9%87%91%E7%8E%95&rft.au=%E9%99%88%E6%B4%81&rft.date=2022-08-01&rft.pub=%E6%B5%99%E6%B1%9F%E5%A4%A7%E5%AD%A6%E5%8C%BB%E5%AD%A6%E9%99%A2%E9%99%84%E5%B1%9E%E5%84%BF%E7%AB%A5%E5%8C%BB%E9%99%A2%E6%B6%88%E5%8C%96%E5%86%85%E7%A7%91%2F%E5%9B%BD%E5%AE%B6%E5%84%BF%E7%AB%A5%E5%81%A5%E5%BA%B7%E4%B8%8E%E7%96%BE%E7%97%85%E4%B8%B4%E5%BA%8A%E5%8C%BB%E5%AD%A6%E7%A0%94%E7%A9%B6%E4%B8%AD%E5%BF%83%2C%E6%B5%99%E6%B1%9F%E6%9D%AD%E5%B7%9E+310052&rft.issn=1008-8830&rft.volume=24&rft.issue=8&rft.spage=917&rft.epage=922&rft_id=info:doi/10.7499%2Fj.issn.1008-8830.2203006&rft.externalDocID=zgddekzz202208013
thumbnail_s http://utb.summon.serialssolutions.com/2.0.0/image/custom?url=http%3A%2F%2Fwww.wanfangdata.com.cn%2Fimages%2FPeriodicalImages%2Fzgddekzz%2Fzgddekzz.jpg