摘要
Abstract
Objective To explore clinical features and diagnostic methods of Jaccoud's arthropathy (JA) to avoid misdiagnosis and mistreatment. Methods Clinical data of a patient with JA misdiagnosed as rheumatoid ar-thritis (RA) previously were retrospectively analyzed,and related literature was reviewed. Results The 61-year-old female patient was admitted for polyarthrosis for 20 years, who was diagnosed as having RA in Traditional Chinese Medicine Department in our hospital and Department of Rheumatology and Immunology of Nanjing Gulou Hospital. Methotrexate and hydroxychloroquine were taken discontinuously. Some tests conducted after admission revealed neg-ative RF and anti-ccp antibody. The levels of ESR, CRP and complement C3 were 33 mm/h,1. 1 mg/L and 0.85 g/L,resptctively. Anti-nuclear antibody (ANA) was positive 1: 1000 (granule type) and 1: 100(cytoplas-mic granule type). ENA test showed anti-nRNP/Sm, anti-SSA, anti-ro52, and anti-mitochondrial antibody turned out to be positive,and anti-ssb,anti-histidine antibody were positive. There was abnormal changes in local density and morphology but no bone destruction according to X-ray examination of both hands. We diagnosed her with Sjogren's syndrome and Jaccoud's arthropathy.Subsequently,she was dicharged after treatment by hydroxychloroquine and total glucosides of paeony as well as by regulating and fight osteoporosis. The patient reported no joint swelling and pain,and was discharged home after relief of dry mouth. Conclusion JA is a rare disease that can be seconda-ry to a variety of diseases. The joint appearance of the affected joints is similar to that of rheumatoid arthritis,there-fore,understanding of the clinical features of the disease may help to avoid misdiagnosis and overtreatment.关键词
Jaccoud关节病/干燥综合征/误诊/关节炎；类风湿Key words
Jaccoud arthropathy/Sjogren's syndrome/Misdiagnosis/Arthritis,rheumatoid分类
医药卫生
