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患者男,71岁。反复午后发热1个月,胸腔积液收入呼吸科。入院后查抗结核抗体:弱阳性;ANA(+);血常规示贫血及白细胞减少。以结核性胸膜炎予抗结核治疗3周无明显好转,短期使用糖皮质激素后病情缓解。患者继续抗结核治疗4月后皮疹加重。查ANA1:3200(+),Histone抗体(+);dsDNA-IgG194.8IU/mL,结合患者关节炎、皮疹、胸膜炎及贫血等病史,诊断:系统性红斑狼疮。予口服强的松15mg1次/d,羟氯喹100mg2次/d,症状缓解,随访半年病情稳定。
Patient male, 71 years old. Repeated afternoon fever 1 month, pleural effusion income respiratory department. Check anti-TB antibodies after admission: weakly positive; ANA (+); blood shows anemia and leukopenia. To tuberculous pleurisy to anti-tuberculosis treatment for 3 weeks without significant improvement, short-term use of glucocorticoid after remission. Patients continued rash therapy after 4 months of rash. ANA1: 3200 (+), Histone antibody (+); dsDNA-IgG194.8IU / mL, combined with patients with arthritis, rash, pleurisy and anemia and other medical history, diagnosis: systemic lupus erythematosus. To oral prednisone 15mg1 times / d, hydroxychloroquine 100mg2 times / d, symptoms relieved, six months follow-up stable condition.