白塞病37例临床误诊分析

发布时间：2018-12-29 09:31

【摘要】：目的分析37例白塞病误诊的原因,加深临床医师对本病的认识。方法收集本科2009年1月-2015年12月曾经误诊的白塞病37例,对其临床表现、误诊的疾病和科室进行原因分析。诊断标准采用2014年白塞病的国际标准评分系统。结果临床表现中,口腔溃疡37例(100%),结节性红斑18例(48.65%),针刺反应阳性22例(59.46%),生殖器溃疡9例(24.32%),眼部病变15例(40.54%),关节疼痛13例(35.13%),毛囊炎13例(35.13%),紫癜样皮损2例(5.40%),多形红斑样皮损和神经病变各1例(2.70%)。误诊为结节性红斑15例(40.54%),阿弗他溃疡9例(24.32%),巩膜炎及结膜炎6例(16.22%),外阴溃疡2例(5.40%),固定性药疹2(5.40%);复发性生殖器疱疹、过敏性紫癜1例和脑梗死各1例(2.70%)。结论白塞病临床表现多样,因首发症状不一而就诊科室不同;本病的诊断没有特异性的血清学诊断,所以需要综合考虑,避免临床上误诊或漏诊。
[Abstract]:Objective to analyze the causes of misdiagnosis in 37 cases of Behcet's disease. Methods 37 cases of Behcet's disease which were misdiagnosed from January 2009 to December 2015 were collected. The clinical manifestations, misdiagnosed diseases and the causes of misdiagnosis were analyzed. The diagnostic criteria were based on the 2014 international standard scoring system for Behcet's disease. Results there were 37 cases (100%) of oral ulcer, 18 cases (48.65%) of erythema nodule, 22 cases (59.46%) of positive acupuncture reaction, 9 cases (24.32%) of genital ulcer, 15 cases (40.54%) of ocular diseases. There were 13 cases of joint pain (35.13%), 13 cases of folliculitis (35.13%), 2 cases of purpura lesions (5.40%), 1 case of polymorphic erythematoid lesions and 1 case of neuropathy (2.70%). 15 cases (40.54%) were misdiagnosed as nodular erythema, 9 cases (24.32%) were aphthous ulcer, 6 cases (16.22%) were scleral inflammation and conjunctivitis, 2 cases (5.40%) were vulvar ulcer, 2 (5.40%) were fixed drug rash. Recurrent genital herpes, Henoch-Schonlein purpura in 1 case and cerebral infarction in 1 case (2.70%). Conclusion the clinical manifestations of Behcet's disease are various and the first symptoms are different. The diagnosis of Behcet's disease has no specific serological diagnosis so it should be considered synthetically to avoid misdiagnosis or missed diagnosis.
【作者单位】：云南省曲靖第一人民医院(昆明医科大学附属曲靖医院)皮肤科;
【分类号】：R597.9

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