不明原因发热伴反复低钠血症一例的分析及文献复习
| 作者: |
1章丽珠,
1杨磊,
1黄强,
1曹佳宁,
1陈英,
2韩志君,
3任天丽,
1杨承健
1 南京医科大学附属无锡市第二人民医院 心血管内科, 江苏无锡 214002 2 南京医科大学附属无锡市第二人民医院 检验科, 江苏无锡 214002 3 南京医科大学附属无锡市第二人民医院 风湿科, 江苏无锡 214002 |
| 通讯: |
杨承健
Email: doctory2071@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2014.06.041 |
摘要
目的：探讨成人Still病(adult-onset Still’s disease，AOSD)的临床特点、鉴别诊断，提高诊断准确 性。方法：回顾性分析1例不明原因发热(fever of unknown origin，FUO)伴反复低钠血症患者的发 病过程、检查指标、治疗经过等临床特征并进行AOSD的文献复习。结果：综合患者长期发热，体 温≥39 ℃，有关节痛2周以上，白细胞、中性粒细胞升高、肝功能损害、咽痛、RF、ANA阴性等 临床表现，患者诊断为AOSD。结论：AOSD的临床表现及实验室检查缺乏特异性，当合并其他临 床表现时诊断更为复杂。对于FUO病人诊断AOSD时主要依据临床表现，同时要排除其他疾病。
关键词：
成人Still病
不明原因发热
低钠血症
诊断
A case of fever of unknown origin with hyponatremia and literature review
CorrespondingAuthor: YANG Chengjian Email: doctory2071@sina.com
DOI: 10.3978/j.issn.2095-6959.2014.06.041
Abstract
Objective: To investigate the clinical features and differential diagnosis of adult-onset Still’s disease and improve its diagnostic accuracy. Methods: The clinical data including pathogenesis, examination index and treatment course of a case of fever of unknown origin with hyponatremia were retrospectively analyzed. Results: According to the clinical manifestation such as long term fever (≥39 ℃), arthralgia lasting ≥2 weeks, leukocytosis, liver dysfunction, sore throat and negative RF and negative ANA, the diagnosis of adult-onset Still’s disease was established. Conclusion: The clinical features and laboratory findings of adult-onset Still’s disease are not specific, yet it is more difficult when associated with other clinical symptoms .When adult-onset Still’s disease is ruled out in a patient with fever of unknown origin, clinical manifestations are the main basis, in addition it is necessary to exclude other disease.