论文部分内容阅读
本文报告一例67岁、女性患者,在20年内先后发生原发性甲状腺机能减退同时伴有皮肌炎、疱疹样皮炎和干燥综合征.1960年开始患甲状腺机能减退.1974年当停用甲状腺药物2周后,实验室指标包括T4、TSH、抗甲球蛋白抗体等均证实此诊断.替代疗法2月后,又恢复到正常.同年发生坐位时站起困难.根据检查发现近端肌无力,此时肘部出现红斑性丘疱疹伴瘙痒.肌肉活检示炎症和变性改变及肌病型肌电图.CPK600u(正常<175u).诊断为多发性肌炎.每日服强的松40mg,肌无力明显好转,肘部皮疹消退,数周内CPK也恢复正常.但肌无力症状尚存在.以后强的松减为每日15mg.
This article reports a 67-year-old female patient with a history of primary hypothyroidism followed by dermatomyositis, herpetic dermatitis and Sjögren’s syndrome within 20 years beginning with hypothyroidism starting in 1960. When thyroid drugs were discontinued in 1974 Two weeks later, laboratory tests, including T4, TSH, anti-B-globulin antibodies, confirmed the diagnosis.2 months after replacement therapy returned to normal, the same year occurred when sitting position difficulties.According to the examination found that the proximal muscle weakness, At this time there erythema erythema with herpes eczema with muscle biopsy showed changes in inflammation and degeneration and myopathy EMG.CPK600u (normal <175u.) Diagnosis of polymyositis daily dose of prednisone 40mg, muscle Inability to significantly improve, elbow rash subsided, CPK also returned to normal within a few weeks.But myasthenia gravis symptoms still exist after strong relaxant 15mg daily.