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頁籤選單縮合
題名 | Spontaneous Pneumomediastinum--A Rare Complication in Dermatomyositis=自發性氣縱隔--皮肌炎之罕見併發症 |
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作者 | 陳昭宏; 陳炯睿; 張漢煜; | 書刊名 | 胸腔醫學 |
卷期 | 26:3 2011.06[民100.06] |
頁次 | 頁153-159 |
分類號 | 415.45 |
關鍵詞 | 自發性氣縱隔; 皮肌炎; 多發性肌炎; 間質性肺病; 類固醇; 環孢靈; Spontaneous pneumomediastinum; Dermatomyositis; Polymyositis; Interstitial lung disease; Corticosteroid; Cyclosporine-A; |
語文 | 英文(English) |
中文摘要 | 皮肌炎普遍以肌炎與典型的皮膚症狀來表現,且常見與間質性肺病相關。然而自發性氣縱隔在皮肌炎已被發現是一種罕見的併發症。在此,我們描述一個57歲的女性被診斷為皮肌炎,有潰瘍性皮膚損傷與間質性肺炎的表現,並且發生罕見的自發性氣縱隔合併厲害的皮下氣腫之併發症。儘管用高劑量之類固醇,漸進性的潰瘍性皮膚損傷與頑固性自發性氣縱隔依然發生。當合併類固醇、氧氣,與環孢靈的治療,潰瘍性皮膚損傷與自發性氣縱隔之情形獲得改善。病人出院六個月後依然在門診追蹤。根據過去的研究,自發性氣縱隔與支氣管壞死相關而非之前所認定是間質性肺病造成。血管病變造成支氣管壁壞死被認為才是造成氣縱隔的原因。 |
英文摘要 | Dermatomyositis is a generalized disorder characterized by myositis and typical cutaneous findings. Dermatomyositis is commonly associated with interstitial lung disease. However, spontaneous pneumomediastinum has been reported as a rare complication in dermatomyositis. Herein, we describe a 57-year-old female patient with dermatomyositis who had the complications of spontaneous pneumomediastinum and extended subcutaneous emphysema. The progressive ulcerative skin lesions were accompanied by refractory pneumomediastinum despite relatively high-dose corticosteroids. The ulcerative skin lesions and pneumomediastinum resolved successfully after treatment with oxygenation therapy and corticosteroids in combination with cyclosporine-A. The patient remained well during more than 6 months of outpatient follow-up after discharge. According to previous studies, spontaneous pneumomediastinum is not associated with interstitial lung disease, but with bronchial necrosis. Necrosis of the bronchial wall caused by focal ischemia due to vasculopathy could result in air leakage with resultant pneumomediastinum. |
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