肺炎支原体感染在成人斯蒂尔病发病中的作用
The Role of Mycoplasma pneumoniae Infection in the Pathogenesis of Adult-Onset Still’s Disease
DOI: 10.12677/acm.2025.1561695, PDF,    科研立项经费支持
作者: 王澳华, 段玉婷, 廖桢宇：青岛大学附属医院老年医学科，山东 青岛；青岛大学青岛医学院，山东 青岛；胡 松, 毛拥军*：青岛大学附属医院老年医学科，山东 青岛
关键词: 成人斯蒂尔病(AOSD)；肺炎支原体；炎症；免疫学；诊断；Adult-Onset Still’s Disease (AOSD)； Mycoplasma pneumoniae； Inflammation； Immunology； Diagnosis
摘要: 成人斯蒂尔病(Adult-onset Still’s Disease, AOSD)是一种罕见的全身性的自身炎症性疾病，常累及全身多器官系统，表现出非特异性的症状和体征。AOSD非特异性的临床表现使其诊断往往面临着重大挑战。感染是AOSD的主要诱因，并且与其临床特征高度重叠，比如发热、白细胞和炎症因子的升高等，因而易导致AOSD的误诊或漏诊。许多病原体均可诱发AOSD起病，但目前关于肺炎支原体感染继而发生AOSD的病例报告较为罕见。我们报告了一例最初诊断为单纯肺炎支原体相关上呼吸道感染的AOSD病例。一名21岁的年轻女性，主要表现为反复高热，同时伴有关节疼痛、皮疹及浅表淋巴结肿大，在排除了感染性疾病、恶性肿瘤及其他自身免疫性疾病后，根据Yamaguchi标准最终确诊为AOSD。应用激素治疗后，患者的病情明显好转，随访记录显示病情控制稳定。此外，我们就AOSD的临床特征及诊疗原则进行了详细的讨论及文献综述，重点阐明了肺炎支原体感染与AOSD发病之间的内在联系，并进一步揭示了两者在发病机制中的密切关联。
Abstract: Adult-onset Still’s Disease (AOSD) is a rare systemic inflammatory disease, which often accumulates multiple organ systems and shows nonspecific symptoms and signs. The nonspecific clinical manifestations of AOSD make its diagnosis often face great challenges. Infection is the main inducement of AOSD, and it highly overlaps with its clinical features, such as fever, increase of white blood cells and inflammatory factors, which easily leads to misdiagnosis or missed diagnosis of AOSD. Many pathogens can induce the onset of AOSD, but at present, there are few cases of AOSD caused by Mycoplasma pneumoniae infection. We report a case of AOSD initially diagnosed as simple Mycoplasma pneumoniae associated with upper respiratory tract infection. A 21-year-old young woman with recurrent high fever, joint pain, rash and superficial lymphadenopathy was finally diagnosed as AOSD according to Yamaguchi criteria after excluding infectious diseases, malignant tumors and other autoimmune diseases. After hormone therapy, the patient’s condition improved obviously, and the follow-up records showed that the condition was stable. In addition, we discussed the clinical characteristics and principles of diagnosis and treatment of AOSD in detail and reviewed the literature, focusing on the internal relationship between Mycoplasma pneumoniae infection and the pathogenesis of AOSD, and further revealed the close relationship between them in the pathogenesis.
文章引用：王澳华, 胡松, 段玉婷, 廖桢宇, 毛拥军. 肺炎支原体感染在成人斯蒂尔病发病中的作用[J]. 临床医学进展, 2025, 15(6): 29-38. https://doi.org/10.12677/acm.2025.1561695

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