文献简介

出版社:JAMA Dermatology

作  者:Jennifer M. E. Boggs, MB, BCh, BAO; Catherine C. Foley, MB, BCh, BAO; Mary E. Laing, MB, BCh, BAO, FRCPI, MMSc, HDip. Clin Ed, PhD

编  号:

关键字:淀粉样变性

年  份:2017   点击量:251

文献摘要 全文翻译

A man in his 80s presented with a 1-year history of purpura, ecchymoses, anorexia, and weight loss. His medical history included alcohol abuse and cognitive impairment. Purpura and ecchymoses, initially periorbital, progressed over the previous 12 months. Elder abuse was excluded. Examination demonstrated waxy yellow papules and plaques with purpura in the periocular, neck, axillary, trunk, and inguinal regions (Figure, A). Investigations revealed anemia, abnormal liver function test results, and renal impairment with moderate proteinuria. The patient’s serum protein electrophoresis (SPEP) and immunofixation urine protein electrophoresis test results were normal. Radiological studies were unremarkable. Subsequently, a 4-mm punch biopsy specimen was obtained (Figure, B-D).

患者男性,80余岁,1年前出现紫癜、瘀斑、厌食和体重减轻。患者病史包括酗酒和认知障碍。最初出现在眶周的紫癜、瘀斑,在过去12个月中不断发展。排除老人被虐待可能。检查发现在眼周、颈部、腋窝、躯干和腹股沟区可见蜡黄色丘疹、斑块伴紫癜(图A)。调查发现患者贫血、肝功能测试异常、肾损害伴中度蛋白尿。患者血清蛋白电泳(SPEP)和免疫固定电泳检测结果均正常。放射检查结果未见异常。随后,取4 mm钻孔活检标本(图B-D)。