最近审阅: 3 十一月 2020
最近更新: 05 五月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 手指苍白/疼痛
  • 关节炎/关节痛
  • 手部肿胀
  • 指端硬化
  • 甲襞血管变化
  • 呼吸困难或咳嗽
  • GORD 和烧心症状
  • 肌痛或肌炎

其他诊断因素

  • 血尿
  • 淋巴结肿大
  • 脱发
  • 皮疹
  • 近端肌肉无力
  • 三叉神经痛
  • 头痛
  • 神经精神性疾病,包括精神病和癫痫发作
  • 周围神经病
  • 发热

危险因素

  • 女性
  • 年龄为 20 至 40 岁
  • 存在特异性 HLA 基因型

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 红细胞沉降率
  • C 反应蛋白 (CRP)
  • 血清尿素和肌酐
  • 类风湿因子
  • 抗核抗体
  • 抗环瓜氨酸肽(抗 CCP)抗体
  • 尿液分析
  • 抗 U1 核糖核蛋白
  • 抗 Jo-1
更多 首要检查

需考虑的检查

  • 肌酸激酶
  • 抗双链 DNA
  • Smith 抗原
  • 抗 SS-A 和抗 SS-B
  • 肺功能试验(肺活量,肺容量,肺弥散功能测定)
  • 胸部 X 线检查 (CXR)
  • 高分辨率胸部 CT 扫描
  • 超声心动图
  • 右心导管术
  • 钡餐
  • 上消化道内镜 ± 活检
  • 受累关节普通 X 线片
  • 肌电图
  • 神经传导检查
  • 肌肉活检
  • 肺活组织检查
  • 肾脏活检
更多 需考虑的检查

新兴检查

  • 抗 Ku 抗体
  • 抗多肌炎/硬皮病抗体
  • 其他抗合成酶抗体(PL7、PL12、OJ、EJ、KS、Ha 等)
更多 新兴检查

治疗流程

进行中

撰稿人

Associate Professor of Medicine

Division of Rheumatology

Miller School of Medicine

University of Miami

Miami

FL

利益声明

LY has developed educational materials for the Duke University workshop on evidence-based practice and received sponsored travel and hotel accommodations as one of the workshop co-directors.

Associate Professor of Medicine

Division of Rheumatology and Immunology

Miller School of Medicine

University of Miami

Miami

FL

利益声明

CL declares that he has no competing interests.

Dr Larry Young and Dr Carlos Lozada would like to gratefully acknowledge Dr Robert Hoffman, a previous contributor to this topic. RH has received NIH grants greater than 6 figures USD. RH is the author of some studies referenced in this topic. RH declares that he has no competing interests.

同行评议者展开全部内容

Associate Professor and Director

Division of Rheumatology and Immunology

University of Arkansas for Medical Sciences

Little Rock

AR

利益声明

RO declares that he has no competing interests.

Professor and Vice Chair

Department of Medicine

University of Wisconsin Hospital

Madison

WI

利益声明

AB declares that he has no competing interests.

Consultant Rheumatologist and Honorary Senior Clinical Lecturer in Rheumatology

Selly Oak Hospital

Birmingham

UK

利益声明

SB declares that he has no competing interests.

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