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《中国实用内科杂志》2016,(2)
正1病历资料患者女,31岁,因"活动后呼吸困难2年余,加重3个月"主诉于2014-05-07入院。患者2年余前始出现活动后呼吸困难,休息后可好转,无发热、咳嗽、咳痰、咯血、胸痛、关节肿痛、反复口腔溃疡、脱发、光过敏等,症状进行性加重。于3个月前平路步行100 m即出现呼吸困难,1周余前活动后"晕倒",数分钟后自行好转,于外院行心脏彩超提示肺动脉高压(PAH)。查N末端B型利钠肽原(NT- 相似文献
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病例:患者女,52岁,因"反复腹泻伴下腹痛2个月,加重半个月"于2007年8月21日收治入院。患者于2个月前无明显诱因下出现腹泻,大便呈糊状,偶有鲜血,每日约5~6次。伴有下腹痛,排便后缓解。无畏寒、发热,无里急后重、关节肿痛、皮疹。于外院就诊后间断口服止泻药物治疗 相似文献
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银屑病关节炎发生血液系统肿瘤机会高于一般人群 ,但合并白血病少见 ,本例长期服用中药制剂治疗 ,合并白血病 ,现报告如下。患者 :男性 ,31岁。因反复皮疹 5年 ,加重伴关节肿痛 ,体重下降 2个月于 2 0 0 0年 5月 2 7日入院。患者 5年前反复出现四肢、躯干红色皮疹 ,呈钱币样 ,表皮角化、脱屑 ,诊断为“银屑病” ,一直服中药制剂 (具体成分不详 )。 2个月前皮疹加重 ,同时出现关节肿痛 ,累及右手远端指间关节及双膝、双踝关节 ,伴晨僵 ,有腰痛 ,无发热。当地医院予地塞米松治疗 ,关节肿痛无好转。我院查HLA B2 7(- ) ,红细胞沉降率(ES… 相似文献
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类风湿关节炎 (rheumatoidarthritis,RA)肾损害并不多见[1] ,我们遇到 1例RA患者并发肾病综合征 (NS)及严重的肾小管间质病变 ,现报告如下。患者 :女性 ,5 3岁。因双手关节肿痛伴晨僵反复发作 6年 ,双下肢水肿 1个月于 2 0 0 0年 6月 12日入院。 1994年初患者无诱因掌指、近指、腕等关节对称性肿痛 ,伴晨僵 (每天超过 1h)。 1994年 10月上述关节肿痛加重 ,查血类风湿因子阳性 ,诊断为RA ,间断服用消炎痛等药。 1998年 6月起 ,因关节肿痛明显加重持续服用青霉胺 (0 5mg/d)及双氯灭痛 (75mg/d)至入院。 2 … 相似文献
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Rheumatoid arthritis after rubella 总被引:7,自引:0,他引:7
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The association of Takayasu's arteritis with other rheumatic disease is rare. We report a 37-year-old female who developed Takayasu's arteritis in her 20s and subsequently developed rheumatoid arthritis. 相似文献
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Sixteen patients with aseptic arthritis developing after gonorrhoea and 14 patients with arthritis after nongonococcal urogenital infection have been analysed with respect to clinical course, roentgenological signs, and humoral as well as cellular immune responses to Neisseria gonorrhoeae antigen. Fifty-eight healthy blood donors were used as controls. The clinical pattern did not differ significantly between the 2 groups. Eye or skin lesions indicative of Reiter's syndrome were found in 5 patients of both groups. Signs of sacroiliac arthritis were found in 8 and 6 patients respectively. Gonococcal complement fixation was positive in 9 of 16 patients in the postgonorrhoeal arthritis group and in 0 of 14 patients in the arthritis group with nongonococcal urogenital infection. The lymphocyte stimulation induced by gonococcal antigen was significantly greater in patients with postgonorrhoeal arthritis than in healthy controls. When reference was made to the results of stimulation of the lymphocytes with PPD, there was also a significant difference in the lymphocyte reactivity to gonococcal antigen between the group of patients with postgonorrhoeal arthritis and that of patients with arthritis after non-gonococcal urogenital infection. No such difference was noted between the latter group and the healthy controls. The clinical and immunologic data argue in favour of the hypothesis that Neisseria gonorrhoeae may induce an aseptic arthritis which sometimes presents as a complete Reiter's syndrome. 相似文献
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We describe 4 patients successfully treated with intraarticular osmic acid for post-infectious arthritis persisting after apparent eradication of bacteria from the infected joint. In addition the bactericidal effect of osmic acid in vitro is demonstrated. We conclude that treatment with osmic acid carries no risk of iatrogenic infection; on the contrary, an antibacterial effect seems likely. 相似文献
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Reactive arthritis after hepatitis B vaccination 总被引:3,自引:0,他引:3
E Hachulla E Houvenagel A Mingui G Vincent A Laine 《The Journal of rheumatology》1990,17(9):1250-1251
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In August 1991 the Institute of Medicine released a report entitled "Adverse Effects of Pertussis and Rubella Vaccines" that examined, among other relations, the relation between immunization with the RA 27/3 rubella vaccine strain and chronic arthritis. The committee spent 20 months reviewing a wide range of information sources including case series and individual case reports published in peer-reviewed journals and reported by vaccine manufacturers; unpublished case reports from physicians, parents, and other concerned persons; epidemiological studies; and laboratory studies. There were no animal studies available. The committee found that the evidence is consistent with a causal relation between the RA 27/3 rubella vaccine strain and chronic arthritis in adult women, although the evidence is limited in scope. Proving that rubella vaccination can cause chronic arthritis will require a better understanding of pathogenetic mechanisms and additional well-designed studies. We briefly describe the committee's evaluative methods and present the evidence underlying its conclusion. 相似文献
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Rheumatoid arthritis (RA) and polymyositis (PM) are distinct clinical syndromes. The concurrent diagnoses of RA and PM in the same patient are rare. We describe a patient who developed outright PM after 16 years of well established RA, review the literature, and highlight the need to consider a broad base of differentials including PM in the diagnosis of muscle weakness in RA. 相似文献