甲巯咪唑致药物性狼疮

1例35岁女性患者因甲状腺功能亢进症给予甲巯咪唑（10 mg，1次/d）、维生素 B4（10 mg，3次/d）和鲨肝醇片（50 mg/片，1片/次，3次/d）口服。服药1周，因白细胞计数降低，甲巯咪唑减量至10 mg，1次/d，同时加用盐酸小檗胺片（4片，3次/d）。服药16 d，患者出现发热，体温最高至37.8℃，四肢出现红色皮疹、瘙痒，伴周身关节疼痛。服药10 d，双手食指及中指近端指间关节、右手食指及中指掌指关节轻微肿胀、压痛（﹢），双腕关节、双踝关节及双膝关节压痛（﹢）。实验室检查：红细胞沉降率41 mm/1 h，C反应蛋白31 mg/L，抗核抗体（ ANA）1：310，组蛋白抗体（ AHA）（﹢）。停用甲巯咪唑，其他药物继续原剂量口服。随后，患者关节疼痛和肿胀情况逐渐好转。停药半年后， ANA和AHA转为阴性。

Thiamazole-induced lupus

A 35-year-old female patient received oral thiamazole 10 mg twice daily,vitamin B4 10 mg thrice daily,and two tablets of batilol tablets（50 mg per tablet）thrice daily for hyperthyroidism. On week 1 of medication,because of decreasing level of white blood cells,thiamazole was reduced to 10 mg once daily and four tablets of berbamine hydrochloride tablets thrice daily were added to the regimen. On day 16 of medication,the patient experienced fever with a peak temperature of 37. 8 ℃ and red rash and itching on the limbs followed by generalized arthralgia. On day 10,slight swelling and positive tenderness appeared on proximal interphalangeal joints of index fingers and middle fingers of both hands,and metacarpopha-langeal joints of right index finger and middle finger. Positive tenderness also appeared on her both wrist joints,both ankle joints,and bilateral knee joints. Laboratory tests revealed the following values：erythrocyte sedimentation rate 41 mm/1 h,C-reactive protein 31 mg/L,antinuclear antibodies（ ANA）1 ：310,and anti-histone antibodies（ AHA）（ ﹢）. Thiamazole was stopped while the other drugs were continued as before.＆amp;nbsp;Subsequently,the symptoms of pain and swelling of her joints gradually improved. After half a year of drug withdrawal,the ANA and AHA became negative.