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患者女,66岁,农民。因游走性多关节疼痛伴发热3月于1987年7月1日入院。患者3月前采茶劳动后感两侧膝、踝、髋,肘关节疼痛,呈对称性、游走性发作,伴发热,乏力、纳差。经乡卫生院按“风湿热,风湿性关节炎”治疗约半月,症状无改善,遂转我院,既往身体健康,无关节炎史。体检:体温37.4℃,面色苍白,轻度贫血貌,浅表淋巴结未触及,心肺听诊正常,腹平软无压痛,肝脾肋下未触及,未触及腹部肿块,膝、肩、肘、踝关节轻度肿、压痛(+),无活动障碍,全身皮肤未见皮疹及色素沉着斑。实验室检查:Hb94g/L,WBC40×10~9/L,N0.92,L0.08,血小板计数120×10~9/L,血沉40mm/h,血清谷丙转氨酶40u以下,血清白蛋白28g/L,球蛋白
Female patient, 66 years old, farmer. Painful multijoint pain with fever was admitted to hospital on July 1, 1987 in March. The patient had felt pain on both knees, ankles, hips, and elbow joints after taking tea labor three months ago. Symptoms and migratory seizures were associated with fever, fatigue, and anorexia. After being treated with rheumatic fever and rheumatoid arthritis by the township hospital for about half a month, the symptoms did not improve. He was transferred to our hospital and was previously healthy and had no history of arthritis. Physical examination: body temperature 37.4°C, pale, mild anaemia, superficial lymph nodes not touched, heart and lung auscultation normal, abdominal softness without tenderness, liver and spleen not touched under the ribs, no contact with abdominal mass, knee, shoulder, elbow, ankle Mild swelling, tenderness (+), no movement disorder, no rash and pigmentation spots on the whole body skin. Laboratory tests: Hb94g/L, WBC40×10~9/L, N0.92, L0.08, platelet count 120×10~9/L, ESR 40mm/h, serum alanine aminotransferase 40u or less, serum albumin 28g /L, globulin