抗TIF1-γ抗体、抗核抗体ANA及抗GAD65抗体等多重抗体阳性的成人皮肌炎一例并文献回顾

A Case of Adult Dermatomyositis with Multiple Positive Antibodies, Including Anti-TIF1-γ Antibodies, Anti-Nuclear Antibodies (ANA), and Anti-GAD65 Antibodies, and Literature Review

摘要: 皮肌炎(dermatomyositis, DM)是一种由自身免疫介导的主要累及皮肤和肌肉，也可能损伤心、肺、肾及消化道等多个系统的弥漫性骨骼肌炎症性结缔组织病，少数患者合并其他自身免疫病，如类风湿性关节炎、系统性红斑狼疮及进行性系统性硬化等。典型临床表现为对称性四肢近端肌肉无力、肌肉疼痛、眶周和上下眼睑水肿性淡紫色斑和Gottron征。遗传、感染、免疫及肿瘤等均可能参与发病。多数患者血清或脑脊液可检测到一种类型自身抗体，而多种自身抗体重叠较罕见。本研究分析了2023年3月1日就诊于陕西省人民医院神经内一科的1例多重自身抗体阳性的皮肌炎，并结合文献从发病机制、临床表现、辅助检查及治疗等方面进行讨论。本次研究经过本院医学伦理委员会同意。

Abstract: Dermatomyositis (DM) is a diffuse skeletal muscle inflammatory connective tissue disease primarily affecting the skin and muscles, which can also damage multiple systems such as the heart, lungs, kidneys, and digestive tract. A minority of patients may also develop other autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and progressive systemic sclerosis. Typical clinical manifestations include symmetrical weakness of the proximal muscles of the limbs, muscle pain, periorbital and eyelid edema with a dusky violet color, and Gottron’s sign. Genetic fac-tors, infections, immune dysregulation, and tumors may all contribute to the development of the disease. Most patients can be detected with a specific type of autoantibody in their serum or cere-brospinal fluid, although the overlap of multiple autoantibodies is rare. This study analyzed a case of dermatomyositis with multiple positive autoantibodies, which was treated at the Department of Neurology, Shaanxi Provincial People’s Hospital on March 1, 2023, and conducted a discussion on the pathogenesis, clinical manifestations, auxiliary examinations, and treatment based on existing literature. This study was approved by the Medical Ethics Committee of our hospital.