2025年 · 第105卷第41期

A 61-year-old male was seen in Liaocheng People's Hospital of Shandong Province on February 13, 2025 due to "dull abdominal pain for 2 months". The patient had a 20-year history of hepatitis B and underwent partial hepatectomy for hepatocellular carcinoma 10 years ago (23 Jan 2015). In order to regulate liver function after operation, Chinese medicine containing gardenia was taken for 9 years. Abdominal physical examination and laboratory examination showed no abnormalities. The abdominal plain CT scan (Figures 1 and 2, shown by arrows) and the enhanced portal vein phase maximum density projection images (Figures 3 and 4, shown by arrows) showed thickening and edema of the ascending and transverse colon walls, and linear calcification of the mesenteric vein. Colonoscopy revealed that the mucosa of the right colon was congested with a dark purple appearance. Combined with medical history, imaging and endoscopic findings, the diagnosis of idiopathic mesenteric venous sclerosis was confirmed. Because the patient's symptoms are mild, symptomatic treatment is given, and it is recommended to stop the use of traditional Chinese medicine immediately. After 5 months of follow-up (25 Jul 2025), the patient's abdominal symptoms were significantly relieved, and there was no abdominal pain, diarrhea or other gastrointestinal discomfort, and no progression of the lesions was found in the re-imaging examination.

A 61-year-old woman developed joint deformation 20 years ago and intermittent proximal limb muscle pain with squat difficulty for the past 10 years. For the past 5 to 6 years, I have regularly taken prednisone acetate 10 mg once a day. The main symptoms include dry mouth, scrubbing sensation in the eyes and chest tightness. Physical examination showed multiple joint deformations of both hands and feet, and negative tenderness. X-ray examination showed poor alignment and flexion deformity of the distal interphalangeal joints of both hands, and patchy high-density shadows could be seen around some joints, accompanied by local joint space stenosis (Figures 1 and 2). Laboratory tests showed anti-nuclear antibody (ANA) 1:160 (cytoplasmic granular type), anti-SCL70 antibody 45.03 RU/ml, anti-Jo-1 antibody>800 RU/ml, anti-SSA antibody 71.72 RU/ml, anti-U1RNP antibody, anti-dsDNA antibody, anti-SM antibody, rheumatoid factor (RF) and anti-CCP antibody were all negative, anti-mutant citrulline vimentin antibody 27.68 U/ml, serum protein electrophoresis: gamma globulin 22.2%. Chest CT showed interstitial changes in lower lobes of both lungs. Diagnosis: Scleroderma with pulmonary interstitial fibrosis, calcium deposits in the fingers. Prednisone 10 mg once daily +5 mg once nightly, cyclophosphamide 50 mg once every other day and nintedanib 150 mg once daily were given. Patients with scleroderma can develop erosive arthritis, often accompanied by calcium deposits. Unlike diffuse calcium deposits in patients with myositis, calcium deposits in patients with scleroderma tend to be confined to periarticular or trauma sites.