与慢性使用葡萄糖皮质类药物相关的军事型痛风
A Enríquez-Luna1, C Soto-Fajardo1, F Carranza-Enríquez1
1Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico.
Rheumatology international
|October 18, 2023
概括
这一案例突出显示,尽管尿酸水平受到控制,但重复出现的甲状腺痛风与长期使用葡萄糖皮质类药物有关. 它详细介绍了不寻常的"军事类型"皮肤多菲和共存的晶体沉积疾病.
科学领域:
- 类风湿病学 类风湿病学
- 皮肤病学 皮肤病学
- 结晶沉积疾病 结晶沉积疾病
背景情况:
- 长期存在的多发性痛风 (超过30年),多关节性参与和扩散的多发性痛风.
- 病人的病史不良坚持尿酸降低药物和慢性自我处方的全身葡萄皮质激素使用.
研究的目的:
- 为了说明一种罕见的"千里亚尔型"痛风病例与皮内托菲形成.
- 描述尿酸和胆固醇结晶沉积在olecranon痛风囊炎中的共存.
- 为了在广泛的甲状腺痛风中呈现新的超声波发现.
主要方法:
- 病例报告分析了一位患有长期多发性痛风的患者.
- 对病史的审查,包括药物坚持和葡萄糖皮质激素的使用.
- 临床检查,手术切除骨头的骨头,以及他的病理学分析.
- 托菲和受影响关节的超声波成像.
主要成果:
- 一名59岁的男性患有30多年的痛风,出现了复发性,扩散性托菲,包括"miliarial类型"的皮内病变.
- 尽管达到治疗性血清尿酸水平,但新的托菲形成.
- 骨头骨头的手术切除揭示了同时存在的尿酸盐和胆固醇晶体沉积.
- 超声波显示了广泛的病变,提供了新的特征.
结论:
- 在长期的痛风中,尽管控制了血清尿酸盐水平,但可能受到持续使用葡萄糖皮质激素的潜在影响,但可能会出现广泛和反复的托菲形成,包括"miliarial-type"病变.
- 尿酸盐和胆固醇晶体沉积疾病的共存是可能的,在olecranon痛风囊炎.
- 扩展视野超声波可能有助于表征广泛的甲状腺痛风.
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