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患者女,40岁,乡信用社会计。因发烧,腰痛.以肾癌于90年6月2日入院。自1988年起,右肤隐痛,间断出现3～4次原因不明的无痛性的血尿,未治自愈。1989年初,渐感睁眼费力,双眼上睑下垂,尤以在写账目时为著,需用左手指向上支撑眼睑才能工作。并感胸闷、气短、讲话无力,四肢疲软,行走困难,日益加重。曾先后到县、市几家医院求治。同年12月,以重症肌无力、周期性麻痹住某院。神经科检查不支持上述诊断。血常规正常,尿蛋白廿,尿镜检脓球、赤血球满视野,血尿素氮5.1mmol/L,赤治23mm/h,血钾4.6mmol/L,T_a、T_4、RUR,FT_4I均正常胸片(-),心电图正常,双肾B超(-),头部及胸腺CT(-)。肌电图可疑重症肌无力,新斯的明试验(±)。按重症肌无力,神经官能症及泌尿系感染采取抗炎、对症治疗,症状稍好后不久,出现反复高热及
Female patient, 40 years old, rural credit society. Because of fever, low back pain. Kidney cancer was admitted to hospital on June 2, 1990. Since 1988, the right skin has suffered from pain, intermittent painless hematuria of 3 to 4 times unexplained, and has not healed self-healing. At the beginning of 1989, he gradually felt sloppy and his eyes drooped, especially when writing accounts. He needed to support his eyes with his left finger to work. He felt chest tightness, shortness of breath, weak speech, weak limbs, difficulty in walking, and heavier weight. He once went to counties and cities to seek treatment. In December of the same year, a hospital with myasthenia gravis was paralyzed periodically. Neurological examination does not support the above diagnosis. Normal blood routine, urinary proteinuria, urine microscopic examination of pus ball, red blood cell full field, blood urea nitrogen 5.1mmol/L, red rule 23mm/h, blood potassium 4.6mmol/L, T_a, T_4, RUR, FT_4I normal chest radiograph (-), ECG normal, double kidney B-(-), head and thymus CT (-). Electromyogram Suspicious myasthenia gravis, neostigmine test (±). According to myasthenia gravis, neurosis and urinary tract infections to take anti-inflammatory, symptomatic treatment, soon after the symptoms are slightly better, there is repeated high fever and