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病例报告一例正在应用口服铁整合剂 L1期间的18步男性β-地中海贫血患者,怀疑有药物引起系统性红斑狼疮(SLE),其后虽然双股去氧核糖核酸(dsDNA)抗体试验阴性,但患者抗核抗体(ANA)和抗组蛋白抗体阳性——药物性 SLE 的一种三联症特征。后经调查发现患者早在1990年3月其 ANA 已呈阳性,滴度为80,尽管当时螯合剂在继续用。当患者停用了螯合剂1个月时,肝大由16cm 降为8cm,但肝酶仍持续异常,ANA 滴度由80升至160。患者的症状(低热、厌食、恶心、肌肉和关节痛,腹痛)持续存在,口服强的松40mg/d 时有所改善,但仍有症状,他照常有规律地接受输血。在1990年10月的第3周,出现泌尿道感染症状。
Case Report One 18-patient male beta-thalassemia patient undergoing oral iron-chelator L1 was suspected of having drug-induced systemic lupus erythematosus (SLE), although subsequent double-stranded DNA antibody test was negative A Triad Characteristic of Patient Antinuclear Antibodies (ANAs) and Anti-Histone Antibody Positive-Drug SLEs. After the investigation found that patients as early as March 1990 had its ANA positive, titer of 80, although the chelating agent is still in use. When the patient stopped using the chelator for 1 month, the liver size was reduced from 16 cm to 8 cm, but the liver enzymes continued to be abnormal. The ANA titer increased from 80 to 160. The patient’s symptoms (hypothermia, anorexia, nausea, muscle and joint pain, abdominal pain) persisted, with oral prednisone 40 mg / d improved but symptoms remained and he routinely received blood transfusions. In the third week of October 1990, the symptoms of urinary tract infection appeared.