每日一题_2024.05.04

A 62-year-old man presented to the hospital with a 1-month history of muscle aches and weakness in the anterior thighs and the lower posterior aspect of both legs and weight loss of 10 kg. On physical examination, there was numbness of the anterior thighs and posterior lower legs but no skin changes or abdominal tenderness. Laboratory tests showed elevated levels of inflammatory markers. Findings on computed tomography of the chest, abdomen, and pelvis were unremarkable. Tests for antineutrophil cytoplasmic antibodies were negative. Abdominal angiography was performed, shown in the left and right images. What other condition is associated with this patient’s diagnosis?

一名62岁男性因前大腿和双腿下部后侧肌肉疼痛和无力，以及体重下降10公斤，持续1个月而前往医院。体格检查发现前大腿和后小腿麻木，但没有皮肤变化或腹部压痛。实验室检测显示炎症标志物水平升高。胸部、腹部和盆腔的计算机断层扫描结果无异常。抗中性粒细胞胞浆抗体检测为阴性。进行了腹部血管造影，左侧和右侧图像显示。与这位患者的诊断相关的其他疾病是什么？

A. Chronic lymphocytic leukemia 慢性淋巴细胞性白血病

B. Hepatitis B

C. HIV

D. Systemic lupus erythematosus系统性红斑狼疮

E. Tuberculosis结核

答案解析：

乙型肝炎的血清学检测对这位患者是阴性的。对结节性多动脉炎开始使用口服糖皮质激素和环磷酰胺治疗。十天后，发生了肠穿孔，切除的结肠的组织病理学检查显示中等大小动脉壁的中性粒细胞浸润和纤维蛋白样坏死，以及内弹性层的破坏。在出现后的5个月随访中，血管造影显示血管变化的解决。

正确答案：B