Prikaz bolesnika sa Mikuličevom bolesti – savremeni koncept starog entiteta

  • Ksenija Svetozar Bozic Clinic of Rheumatology, Military Medical Academy, Belgrade, Serbia;
  • Branislava Glišić Clinic of Rheumatology, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Olga Radić-Tasić Institute of Pathology, Military Medical Academy, Belgrade, Serbia
  • Bojana Knežević Clinic of Rheumatology, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/7523
Ključne reči: mikulicz' disease||, ||mikuličeva bolest, diagnosis, differential||, ||dijagnoza, diferencijalna, diagnosis||, lacrimal apparatus||, ||suzni aparat, salivary glands||, ||pljuvačne žlezde, immunoglobulin G||, ||IGG, histological techniques||, ||histološke tehnike, glucocorticoids||, ||glukokortikoidi, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Savremena saznanja svrstala su Mikuličevu bolest u grupu bolesti posredovanih imunoglobulinom G4, čija je glavna odlika histološki nalaz limfoplazmocitnih infiltrata, imunoglobulin G4 pozitivnih plazma ćelija, uz storiformnu fibrozu i umerenu eozinofiliju. Prikaz bolesnika. Prikazan je 59-godišnji bolesnik koji je dve godine imao umeren suvi keratokonjuktivitis i uvećane pljuvačne i suzne žlezde. Iako je klinička slika bila karakteristična, ranijim ispitivanjem nije se došlo do dijagnoze Mikuličeve bolesti. Na osnovu tipičnog kliničkog nalaza, visoke serumske koncentracije imunoglobulina G4, uz patohistološki nalaz biopsije tkiva suznih žlezda, dijagnostikovali smo Mikuličevu bolest. Primenjena terapija kortikosteroidima bila je efikasna. Zaključak. Prikazali smo prvog bolesnika u Srbiji sa Mikuličevom bolesti posredovanim imunoglobulinom G4. Našim prikazom istakli smo značaj poznavanja Mikuličeve bolesti posredovane IgG4, kao i diferencijalnu dijagnozu sa Sjögrenovim sindromom i limfoproliferativnim bolestima u reumatološkoj praksi.

 

 


Biografija autora

Ksenija Svetozar Bozic, Clinic of Rheumatology, Military Medical Academy, Belgrade, Serbia;
Clinic of Rheumatology

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Objavljeno
2017/02/01
Broj časopisa
Vol. 73 Br. 4 (2016)
Rubrika
Prikaz bolesnika