沙利度胺致月经不调简

1 例28 岁女性患者,主诉左膝关节肿痛3 年,腰背痛及左髋关节疼痛2 年.左膝关节肿痛起病,腰背痛伴有晨僵及夜间痛,双足跟疼痛,无虹膜炎及强直性脊柱炎（AS）家族史.化验HLA-B27 阳性,ESR 36 mm·h-1,CRP 3.48 mg·dL-1,骶髂关节CT示双侧骶髂关节虫蚀样改变,诊断为强直性脊柱炎,给予洛索洛芬钠及柳氮磺吡啶治疗后,患者左髋关节疼痛好转,但腰背痛症状改善不明显,加用沙利度胺（50 mg,qn）,2 周后给药剂量调至100 mg,qn.服用4 个月后,腰背痛症状明显减轻,晨僵及夜间痛消失,但逐渐出现月经量减少至停经,停用沙利度胺2 个月后症状好转.

Irregular menstruation induced by thalidomide

One 28-year-old young female saw a doctor due to left knee joint pain and swelling for three years, low back painand left hip pain for two years. The patient had left knee joint pain and swelling, low back pain accompanied by morning stiffness andnocturnal back pain, as well as double heel pain. The patient had no history of iritis and family history of the ankylosing spondylitis（AS）. HLA-B27 was positive, erythrocyte sedimentation rate was 36 mm·h-1, C-reactive protein was 3.48 mg·dL-1, and sacroiliacjoint CT showed bilateral sacroiliac joints erosion change. The patient was diagnosed with AS. Loxoprofen sodium and sulfasalazinewere given. The symptom of left hip pain improved after the treatment, but the low back pain did not obviously relieve. Thenthalidomide was given orally with the dose of 50 mg every night, and the dose was added to 100 mg after 2 weeks. Four months later,the symptom of low back pain significantly improved, morning stiffness and nocturnal back pain disappeared. But menstrual bloodvolume of the patient decreased gradually and subsequently the patient developed amenorrhea. Transvaginal ultrasonography showednormal. The symptoms improved after withdrawl of thalidomide for 2 months.