皮肌炎重叠系统性硬化症合并横纹肌溶解症1例并文献复习

目的:提高对重叠综合症继发横纹肌溶解症的认识。方法:报告1例罕见的重叠综合症患者继发横纹肌溶解症病例,并复习相关文献。结果:患者为43岁女性,以皮疹、肌无力2年半,肢端遇冷变色伴皮肤紧硬1年半为主要临床表现,肌酸激酶极度升高,血肌红蛋白、尿肌红蛋白明显高于正常,考虑重叠综合征继发横纹肌溶解症,经血液净化、免疫抑制等治疗临床症状及实验室指标改善。结论:重叠综合征继发横纹肌溶解症临床罕见,当出现急性肾功能衰竭时,与系统性硬化症出现急性肾危象不易鉴别,容易漏诊。

A case report and literature review on polymyositis and progressive systemic sclerosis associated with rhabdomyolysis

Objective: To improve the understanding of overlap syndrome associated with rhabdomyolysis.Methods: A case of overlap syndrome complicated with rhabdomyolysis was reported and the related literatures were reviewed.Results: A 43-year-old woman presented with clinically skin rash,myasthenia weakness,Raynaud's phenomenon and hard skin.Laboratory investigations showed increased blood creatinine kinase(CK),serum and urine myoglobin.After haemodialysis and immunosuppressant treatment,her condition gradually improved.Conclusion: Overlap syndrome associated with rhabdomyolysis is rare,and systemic sclerosis could also have renal crisis,which could lead to miss diagnosis of rhabdomyolysis.