男患,42岁。1980年6月28日以多处关节剧痛1天而急诊入院。6月24日无诱因全身皮肤出现荨麻疹,自觉搔痒,曾用苯海拉明治疗,1天后荨麻疹消失而停药。6月27日再次出现大量荨麻疹并突然出现双侧肩、肘、腕、髋、膝、踝等关节剧痛,以致患者难以忍受,喊叫不止。既往健康。体检:体温36.7℃,脉搏80次/分,血压140/80mmHg。全身皮肤密布荨麻疹,胸背部融合成片,日唇出现水肿。心肺和腹部正常。双铡肩、肘、腕、髋、膝、踝等关节活动受限,压痛明显,外形正常。血象:红细胞4.8×10~(12)/L,白细胞9.4×10~9/L,中性70%,淋巴20%,嗜酸10%。血沉、尿常规、胸透、心电图和肝功能检查 Male suffering, 42 years old. June 28, 1980 with multiple painful joint pain 1 day and emergency admission. June 24 without inducing systemic skin urticaria, self-conscious itching, diphenhydramine therapy has been used, 1 day after the disappearance of urticaria and withdrawal. On June 27, a great deal of urticaria appeared again and suddenly a sharp pain in the joints such as the shoulders, elbows, wrists, hips, knees and ankles caused the patient unbearable. Past health. Physical examination: body temperature 36.7 ℃, pulse 80 beats / min, blood pressure 140 / 80mmHg. Hypertensive systemic skin dense, chest and back into a fusion sheet, lips appear edema. Cardiopulmonary and abdominal normal. Shuangjian shoulder, elbow, wrist, hip, knee, ankle and other joint activity is limited, tenderness, shape normal. Blood: red blood cells 4.8 × 10 12 / L, white blood cells 9.4 × 10 ~ 9 / L, neutral 70%, lymphatic 20%, 10% eosinophilic. ESR, urine routine, chest X-ray, ECG and liver function tests