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患者,女,33岁。因心慌、怕热、多汗、手抖、性情急躁、消瘦乏力5个月于1982年5月入院。查T_428.8μg/dl,T_36.2ng/ml,TSH3.6ng/ml,rT_3 105ng/dl,吸~(131)Ⅰ率2小时65.9%,24小时79.47%;抗甲状腺球蛋白抗体1:32,抗微粒体抗体1:32。诊断为甲状腺机能亢进症。近6～7年来每于太阳晒后面部即脱屑、痒。口腔常有溃疡。1年前面部出现红斑,以冬天明显。体检:头发枯黄、稀疏,面部3～4个小指甲大小之红色斑丘疹,下唇内侧粘膜有直径0.5 cm之溃疡。甲状腺Ⅰ°肿大,可闻及血管杂音。心率120次,第一心音亢进。肝、脾未触及。膝反射稍活跃,手有细颤。实验室检查:血、尿常规无异常发现。类风湿因子1:256;血沉20。ECG示窦性心动过速,T_(Ⅱ、Ⅲ、avF、)
Patient, female, 33 years old. Due to palpitation, fear of heat, sweating, trembling, impatient, weight loss 5 months in May 1982 admitted. Thyroglobulin antibody 1:32, anti-thyroglobulin antibody 1:26, anti-thyroglobulin antibody 1:26, Anti-microsomal antibody 1:32. Diagnosis of hyperthyroidism. Nearly 6 to 7 years for each sun after the face that scaling, itching. Oral ulcers often. 1 year ago, facial erythema, obvious in winter. Physical examination: yellow hair, sparse, facial red nodules of 3 to 4 small fingernail size rash, the lower lip of the inner mucosa ulcers 0.5 cm in diameter. I ° thyroid enlargement, can be heard and vascular murmur. Heart rate 120 times, the first heart sound hyperthyroidism. Liver, spleen not touched. Knee reflex slightly active, hand trembling. Laboratory tests: blood, urine no abnormal findings. Rheumatoid factor 1: 256; ESR 20. ECG showed sinus tachycardia, T_ (Ⅱ, Ⅲ, avF,)