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临床病例讨论 第360例——关节肿痛、全身水肿、发热、肝脾淋巴结肿大

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摘要 病历摘要 患者男,52岁。因关节痛、全身水肿、间断发热、皮疹3个月于2007年5月15日入院。患者2007年2月无明显诱因出现全身对称性可凹性水肿,肢端更明显。随后出现全身多关节肿痛,累及双手近端指间关节、远端指间关节、掌指关节、双腕、双肩、双膝、双踝、双髋、双颞颌关节,对称分布,持续不缓解,双肩不能上抬,双手不能握拳,晨起明显,睡前略缓解。自测体温呈间断性低热(37.8℃),多出现于夜间,发热时伴有畏寒、全身对称性分布红色充血性斑丘疹,部分融合成片,略痒。故来我院免疫科门诊就诊,查血常规、肝肾功能正常;肌酶谱正常;抗核抗体(ANA)(+)S1:40,抗双链DNA、抗可提取核抗原(ENA)、抗角蛋白抗体(AKA)、抗核周因子(APF)、抗环瓜氨酸多肽(CCP)均阴性,ESR9~16mm/1h,C反应蛋白9.6mg/L,类风湿因子(RF)〈20U/ml。
出处 《中华内科杂志》 CAS CSCD 北大核心 2008年第4期350-352,共3页 Chinese Journal of Internal Medicine
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参考文献4

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二级参考文献10

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