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尽管乙型肝炎患者在黄疸发生前见有风湿病症状者高达1/3,但在急性多发性关节炎的鉴别诊断中,人们仍很少考虑乙型肝炎感染。作者报道了3例以多发性关节炎为主要或唯一临床表现的急性乙型肝炎患者。例1为28岁女性,发病前3个月曾有与可疑乙型肝炎患者的性交史。临床表现为几乎所有四肢关节的疼痛、僵硬,并见有左膝关节、两踝关节滑膜炎。化验检查谷草转氨酶(AST)329IU/L,胆红素9mmol/L,HBsAg 阳性。发病15天后出现黄疸,关节痛解除。10周后,HBsAg 阴
Although hepatitis B patients have symptoms of rheumatism up to one third before the onset of jaundice, hepatitis B infection is seldom considered in the differential diagnosis of acute multiple arthritis. The authors report three acute hepatitis B patients with multiple arthritis as the primary or only clinical manifestation. Case 1 was a 28-year-old woman who had had an intercourse with a suspicious hepatitis B patient three months prior to onset. Clinical manifestations of pain in almost all limbs and joints, stiff, and see the left knee, both ankle synovitis. Laboratory tests aspartate aminotransferase (AST) 329IU / L, bilirubin 9mmol / L, HBsAg positive. Jaundice occurred 15 days after onset, joint pain relief. After 10 weeks, HBsAg is negative