论文部分内容阅读
在狼疮性肾炎(LN)中,以显著的完全性远端小管酸中毒(dRTA)为突出表现而无明显肾小球损害者甚少报道,现报告1例。患者女,18岁,反复关节痛、下肢皮疹3年,烦渴、多饮、多尿、软弱、发热半年,于1993年6月5日入院。1989年患者出现双膝关节痛、下肢斑丘疹,诊断为“过敏性紫癜”.此后上述症状反复发作,并出现脱发、口腔溃疡等症状。1992年底出现口渴、多饮(每天4L以上)、多尿(4000ml~±/d)、软弱无力、纳差,一度软瘫,曾查血K~+1.9mmol/L。不久发热38℃～39℃,在当地医院行青霉素、氨苄青霉素、先锋V等抗炎治疗无效,遂转我院。入院前半年未来月经。入院后体检:体温38.4℃,血压10/7 kPa,抬人病房,神志精,精神差,双颈部淋巴结明显肿大。两肺呼吸音粗,左肺底有少许湿罗音,心(一)肝脾不大,全身无水肿,腱反射弱。
In lupus nephritis (LN), with significant complete distal tubule acidosis (dRTA) as the outstanding performance without obvious glomerular damage were rarely reported, one case was reported. Female patient, 18 years old, repeated joint pain, lower extremity rash 3 years, polydipsia, polydipsia, polyuria, weakness, fever for six months, on June 5, 1993 admission. 1989 patients with double knee joint pain, rash lower extremity, diagnosed as “allergic purpura.” After the above symptoms recurrent and appear hair loss, mouth ulcers and other symptoms. The end of 1992, thirst, drank (more than 4L per day), polyuria (4000ml ~ ± / d), weakness, anorexia, was a soft paralysis, had check the blood K ~ +1.9mmol / L. Shortly after the fever 38 ℃ ~ 39 ℃, in the local hospital line penicillin, ampicillin, vanguard V anti-inflammatory treatment is invalid, then transferred to our hospital. The first half of hospitalized menstruation. Physical examination after admission: body temperature 38.4 ℃, blood pressure 10/7 kPa, carried to the ward, conscious spirit, poor spirit, two neck lymph nodes were significantly enlarged. Breath sounds rough two lungs, lungs at the bottom of a little wet rales, heart (a) little liver and spleen, body edema, weak tendon reflexes.