临床荟萃 ›› 2025, Vol. 40 ›› Issue (6): 537-540.doi: 10.3969/j.issn.1004-583X.2025.06.010

• 论著 • 上一篇    下一篇

儿童系统性红斑狼疮合并重症肌无力1例

李少宁, 刘晓雪, 李崇巍, 马继军()   

  1. 天津市儿童医院 天津大学儿童医院 风湿免疫科,天津 300134
  • 收稿日期:2025-03-25 出版日期:2025-06-20 发布日期:2025-07-01
  • 通讯作者: 马继军 E-mail:13920533285@163.com

A case of pediatric systemic lupus erythematosus complicated with myasthenia gravis

Li Shaoning, Liu Xiaoxue, Li Chongwei, Ma Jijun()   

  1. Department of Rheumatology and Immunology, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin 300134, China
  • Received:2025-03-25 Online:2025-06-20 Published:2025-07-01
  • Contact: Ma Jijun E-mail:13920533285@163.com

摘要:

目的 探讨儿童系统性红斑狼疮合并重症肌无力的临床特点、诊疗及转归,提高临床医生对两种疾病共病的重视。方法 回顾性分析1例系统性红斑狼疮合并重症肌无力儿童的临床资料,并复习相关文献。结果 患者女性,16岁,患系统性红斑狼疮2年余,主因言语不清,吞咽困难1周入院。患者重频检测(+)、新斯的明试验(+),抗乙酰胆碱受体抗体IgG(+),诊断重症肌无力。给予甲强龙冲击治疗、静注人免疫球蛋白、溴吡斯的明口服,序贯口服醋酸泼尼松、硫酸羟氯喹、吗替麦考酚酯、阿司匹林治疗原发病。住院9 d症状完全缓解出院。出院6个月重频检测恢复正常,随诊1年无复发。结论 系统性红斑狼疮合并重症肌无力临床少见,两者的关联机制尚不明确,有不典型或轻微症状的患者,应积极完善相关检查,避免误诊和漏诊。

关键词: 红斑狼疮, 系统性, 重症肌无力, 儿童

Abstract:

Objective To explore the clinical characteristics, diagnosis, treatment and prognosis of systemic lupus erythematosus (SLE) complicated with myasthenia gravis (MG) in children, so as to improve clinicians' attention to the coexistence of the two diseases. Methods The clinical data of a pediatric case of SLE combined with MG were retrospectively analyzed, and relevant literatures were reviewed for discussion. Results A 16-year-old female patient with a history of SLE for over 2 years presented due to slurred speech and dysphagia for 1 week. Repetitive nerve stimulation test, neostigmine test, and anti-acetylcholine receptor IgG antibodies were positive, confirming the diagnosis of MG. Treatment regimens included methylprednisolone pulse therapy, intravenous immunoglobulin, oral pyridostigmine bromide, followed by sequential oral prednisone acetate, hydroxychloroquine, mycophenolate mofetil, and aspirin for the primary disease. The patient's symptoms completely resolved after 9 days of hospitalization. At 6 months post-discharge, repetitive nerve stimulation test returned to normal, and no recurrence was observed during 1 year of follow-up.Conclusion The coexistence of SLE and MG is rare in clinical practice, and the underlying mechanisms linking the two conditions remain unclear. For patients with atypical or mild symptoms, relevant tests should be actively conducted to consider this possibility, avoiding clinical misdiagnosis and missed diagnosis.

Key words: lupus erythematosus, systemic, myasthenia gravis, child

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