肋膜積水中發現狼瘡細胞為初始表現之全身性紅斑狼瘡一病例報告

Lupus Erythematosus (LE) Cells in Pleural Fluid as the Initial Manifestation of Systemic Lupus Erythematosus － A Case Report

狼瘡細胞（LE cells）是一種吞噬有其它細胞殘核的嗜中性白血球，常在全身性紅斑狼瘡病人（SLE）身上發現。本文報告一例全身性紅斑狼瘡病人，其初始的表現症狀為胸痛合併肋膜積水。肋膜液細胞學檢查發現含有許多狼瘡細胞，更進一步的免疫學檢查證明，此為一位全身性紅斑狼瘡病人。雖然狼瘡細胞學檢查已被抗核抗體（ANA） 的血清檢驗所取代，且在臨床上已較少被應用。但是當在體液裡、如肋膜液發現有狼瘡細胞，可能暗示此病人為一自體免疫病人，應作更進一步的檢查。我們報告一位罕見的全身性紅斑狼瘡病例，其以在肋膜液裡發現有狼瘡細胞為初始表現症狀。

The lupus erythematosus (LE) cell is a mature neutrophil containing other ingested cell nuclei. These unique cells are usually found in patients with systemic lupus erythematosus (SLE). In this report, we describe a case of SLE with initial manifestations of left chest pain and pleural effusion. Cytological examination of the pleural fluid revealed numerous LE cells that led to the diagnosis of SLE. Although the clinical application of LE cell preparations has been discontinued and the antinuclear antibody (ANA) assay used instead, careful examination of body fluids such as pleural fluid for the presence of LE cells could lead to the discovery of underlying autoimmune disease. The presence of LE cells in pleural fluid has been rarely reported in Taiwan, we herein present an instance of such an initial manifestation in an SLE patient.