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病例报告 31岁、女性,因尿色加深1天而就诊。5天前起感不适,伴发热、畏寒及肌痛。入院3天前出现全身性肌无力,以肢带区最甚,但后2天好转。体温37.5℃,轻度咽炎和中度近端肌无力,尤以腰带区为甚。其余体检正常。尿蛋白(?)及血(?)。镜检见蛋白样碎片,但未见红细胞。分光光度计测定为肌红蛋白尿。血红蛋白10.6g/dl,血片未见红细胞溶解,触珠蛋白和6-磷酸葡萄糖脱氢酶正常。未见镰刀状细胞。谷草转氨酶(AST)2772IU/L、肌酸激酶>10万IU/L。包括抗骨骼肌抗体在内的自身抗体阴性。C-反应蛋白30mg/L。入院后1天左股四头肌活检发现纤维断裂及酸性磷酸酶活性升高,符合肌炎。3周后病人肌强度恢复正常,此时,重复活检发现胎儿
Case report 31 years old, female, deepened due to dark urine one day treatment. Feel uncomfortable 5 days ago, with fever, chills and myalgia. Three days before admission, there was generalized weakness in the limbs, most notably in limb banding, but improved after 2 days. Body temperature 37.5 ℃, mild pharyngitis and moderate proximal muscle weakness, especially in the belt area is staggering. The rest of the physical examination is normal. Urinary protein (?) And blood (?). Microscopic examination of protein-like fragments, but no red blood cells. Spectrophotometer as myoglobinuria. Hemoglobin 10.6g / dl, no erythrocyte lysis in blood, haptoglobin and 6-phosphoglucose dehydrogenase were normal. No sickle-shaped cells. Aspartate aminotransferase (AST) 2772 IU / L, creatine kinase> 100,000 IU / L. Autoantibodies, including anti-skeletal muscle antibodies, are negative. C-reactive protein 30mg / L. One day after admission left quadriceps femoral biopsy found that fiber breakage and acid phosphatase activity increased, consistent with myositis. After 3 weeks, the patient’s muscle strength returned to normal. At this time, the fetus was found by repeated biopsy