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1例35岁女性患者因甲状腺功能亢进症给予甲巯咪唑(10 mg,2次/d)、维生素B_4(20 mg,3次/d)和鲨肝醇片(50 mg/片,2片/次,3次/d)口服。服药2周,因白细胞计数降低,甲巯咪唑减量至10 mg,1次/d,同时加用盐酸小檗胺片(4片,3次/d)。服药16 d,患者出现发热,体温最高至37.8℃,四肢出现红色皮疹、瘙痒,伴周身关节疼痛。服药20 d,双手食指及中指近端指间关节、右手食指及中指掌指关节轻微肿胀、压痛(+),双腕关节、双踝关节及双膝关节压痛(+)。实验室检查:红细胞沉降率42mm/1 h,C反应蛋白32mg/L,抗核抗体(ANA)1:320,组蛋白抗体(AHA)(+)。停用甲巯咪唑,其他药物继续原剂量口服。随后,患者关节疼痛和肿胀情况逐渐好转。停药半年后,ANA和AHA转为阴性。
One 35-year-old female patient was given methimazole (10 mg twice daily), vitamin B 4 (20 mg three times daily) and batyl alcohol tablet (50 mg tablets two tablets daily) due to hyperthyroidism Times, 3 times / d) orally. Take medicine for 2 weeks, due to decreased white blood cell count, methimazole reduced to 10 mg, 1 / d, while adding berberine hydrochloride tablets (4 tablets, 3 times / d). Medication 16 d, patients with fever, body temperature up to 37.8 ℃, red rashes appeared on the limbs, itching, with peri-articular pain. Medication 20 d, both hands index finger and middle finger proximal interphalangeal joint, right index finger and middle finger metacarpophalangeal slight swelling, tenderness (+), double wrist, double ankle and double knee joint tenderness (+). Laboratory tests: erythrocyte sedimentation rate 42mm / 1h, C-reactive protein 32mg / L, anti-nuclear antibody (ANA) 1: 320, histone antibody (AHA) Stop using methimazole, other drugs continue to the original dose oral. Subsequently, the patient’s joint pain and swelling gradually improved. Six months after discontinuation, ANA and AHA turned negative.