Pretibial myxedema(PTM), an uncommon manifestation of Graves' disease(GD), is a local autoimmune reaction in the cutaneous tissue. The treatment of PTM is a clinical challenge. We herein report on a patient with P...Pretibial myxedema(PTM), an uncommon manifestation of Graves' disease(GD), is a local autoimmune reaction in the cutaneous tissue. The treatment of PTM is a clinical challenge. We herein report on a patient with PTM who achieved complete remission by multipoint subcutaneous injections of a long-acting glucocorticoid and topical glucocorticoid ointment application for a self-controlled study. A 53-year-old male presented with a history of GD for 3.5 years and a history of PTM for 1.5 years. Physical examination revealed slight exophthalmos, a diffusely enlarged thyroid gland, and PTM of both lower extremities. One milliliter of triamcinolone acetonide(40 mg) was mixed well with 9 mL of 2% lidocaine in a 10 mL syringe. Multipoint intralesional injections into the skin lesions of the right lower extremity were conducted with 0.5 mL of the premixed solution. A halometasone ointment was used once daily for PTM of the left lower extremity until the PTM had remitted completely. The patient's PTM achieved complete remission in both legs afteran approximately 5-mo period of therpy that included triamcinolone injections once a week for 8 wk and then once a month for 2 mo for the right lower extremity and halometasone ointment application once daily for8 wk and then once 3-5 d for 2 mo for the left lower extremity. The total dosage of triamcinolone acetonide for the right leg was 200 mg. Our experience with this patient suggests that multipoint subcutaneous injections of a long-acting glucocorticoid and topical glucocorticoid ointment application are safe, effective,and convenient treatments. However, the topical application of a glucocorticoid ointment is a more convenient treatment for patients with PTM.展开更多
目的探讨老年自身免疫性肝炎(AIH)患者的临床特征及自身抗体水平。方法回顾性分析2013年1月至2018年1月期间首都医科大学附属北京佑安医院肝病免疫科收治的112例AIH患者的临床资料,按年龄分为老年组(≥60岁,33例)和中青年组(<60岁,79...目的探讨老年自身免疫性肝炎(AIH)患者的临床特征及自身抗体水平。方法回顾性分析2013年1月至2018年1月期间首都医科大学附属北京佑安医院肝病免疫科收治的112例AIH患者的临床资料,按年龄分为老年组(≥60岁,33例)和中青年组(<60岁,79例)。统计分析2组患者临床资料、生化指标和自身抗体指标。采用SPSS 16.0软件进行数据处理,根据数据类型,组间比较分别采用t检验、Mann-Whitney检验或χ~2检验。结果老年组患者乏力(54.5%vs78.5%)和恶心呕吐(18.2%vs 39.2%)症状患者显著少于中青年组,肝硬化(36.4%vs 17.7%)及合并肝外自身免疫病(33.3%vs 16.5%)患者显著多于中青年组,老年患者血小板计数[(155.2±76.1)×109/L vs (186.2±77.2)×109/L]显著低于中青年组,血尿素氮[(5.1±1.6) vs (4.4±1.3)mmol/L]及血肌酐[(62.1±16.2) vs (57.5±15.1)μmol/L]浓度显著高于中青年组,差异均有统计学意义(P<0.05)。老年组抗核抗体阳性率高于中青年组(87.9%vs 79.7%),但差异无统计学意义(P>0.05)。结论老年组AIH患者合并肝硬化、肝外免疫病的比例高,肾功能降低,年龄相关的免疫功能紊乱可能影响患者的临床表现。展开更多
文摘Pretibial myxedema(PTM), an uncommon manifestation of Graves' disease(GD), is a local autoimmune reaction in the cutaneous tissue. The treatment of PTM is a clinical challenge. We herein report on a patient with PTM who achieved complete remission by multipoint subcutaneous injections of a long-acting glucocorticoid and topical glucocorticoid ointment application for a self-controlled study. A 53-year-old male presented with a history of GD for 3.5 years and a history of PTM for 1.5 years. Physical examination revealed slight exophthalmos, a diffusely enlarged thyroid gland, and PTM of both lower extremities. One milliliter of triamcinolone acetonide(40 mg) was mixed well with 9 mL of 2% lidocaine in a 10 mL syringe. Multipoint intralesional injections into the skin lesions of the right lower extremity were conducted with 0.5 mL of the premixed solution. A halometasone ointment was used once daily for PTM of the left lower extremity until the PTM had remitted completely. The patient's PTM achieved complete remission in both legs afteran approximately 5-mo period of therpy that included triamcinolone injections once a week for 8 wk and then once a month for 2 mo for the right lower extremity and halometasone ointment application once daily for8 wk and then once 3-5 d for 2 mo for the left lower extremity. The total dosage of triamcinolone acetonide for the right leg was 200 mg. Our experience with this patient suggests that multipoint subcutaneous injections of a long-acting glucocorticoid and topical glucocorticoid ointment application are safe, effective,and convenient treatments. However, the topical application of a glucocorticoid ointment is a more convenient treatment for patients with PTM.
文摘目的探讨老年自身免疫性肝炎(AIH)患者的临床特征及自身抗体水平。方法回顾性分析2013年1月至2018年1月期间首都医科大学附属北京佑安医院肝病免疫科收治的112例AIH患者的临床资料,按年龄分为老年组(≥60岁,33例)和中青年组(<60岁,79例)。统计分析2组患者临床资料、生化指标和自身抗体指标。采用SPSS 16.0软件进行数据处理,根据数据类型,组间比较分别采用t检验、Mann-Whitney检验或χ~2检验。结果老年组患者乏力(54.5%vs78.5%)和恶心呕吐(18.2%vs 39.2%)症状患者显著少于中青年组,肝硬化(36.4%vs 17.7%)及合并肝外自身免疫病(33.3%vs 16.5%)患者显著多于中青年组,老年患者血小板计数[(155.2±76.1)×109/L vs (186.2±77.2)×109/L]显著低于中青年组,血尿素氮[(5.1±1.6) vs (4.4±1.3)mmol/L]及血肌酐[(62.1±16.2) vs (57.5±15.1)μmol/L]浓度显著高于中青年组,差异均有统计学意义(P<0.05)。老年组抗核抗体阳性率高于中青年组(87.9%vs 79.7%),但差异无统计学意义(P>0.05)。结论老年组AIH患者合并肝硬化、肝外免疫病的比例高,肾功能降低,年龄相关的免疫功能紊乱可能影响患者的临床表现。
