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一名类风湿关节炎女性患者,尽管先前标准治疗失败,但使用拟交感神经胺治疗后顽固性关节炎疼痛显著改善,以及对妊娠晚期不明原因胎儿死亡的可能影响——病例报告

Marked improvement of intractable arthritic pain in a woman with rheumatoid arthritis with sympathomimetic amine treatment despite previous failure with standard therapy and possible implications for last trimester unexplained fetal demise--case report.

作者信息

Boimel P, Check J H

机构信息

Albert Enstein College of Medicine of Yeshiva University, Bronx, NY, USA.

出版信息

Clin Exp Obstet Gynecol. 2007;34(4):254-6.

Abstract

PURPOSE

To determine if sympathomimetic amine treatment could alleviate severe arthritic pain and fatigue associated with rheumatoid arthritis which was refractory to other medical therapy in a patient with a history of unexplained last trimester fetal demise and unexplained cessation of fetal movement and acidosis.

METHODS

A 32-year-old female was treated with 10 mg of dextroamphetamine sulfate daily after failing to gain relief with standard therapy for rheumatoid arthritis.

RESULTS

After several weeks of therapy the patient noticed fewer flare ups of arthritic pain and a marked improvement in her fatigue. Six months on the sympathomimetic amines she noticed improvement in her ability to carry out everyday activities, less flare ups, and increased energy.

CONCLUSIONS

Sympathomimetic amines as demonstrated in this case report can effectively relieve joint pain when conventional therapies for rheumatoid arthritis fail, at least if the water load test is abnormal. Perhaps this therapy could prove beneficial in inhibiting chorionic villitis which can cause fetal death.

摘要

目的

确定拟交感神经胺治疗能否缓解与类风湿关节炎相关的严重关节疼痛和疲劳,该患者对其他药物治疗无效,且有孕晚期不明原因胎儿死亡、不明原因胎动停止和酸中毒病史。

方法

一名32岁女性在类风湿关节炎标准治疗未能缓解后,每天接受10毫克硫酸右旋苯丙胺治疗。

结果

经过几周的治疗,患者注意到关节炎疼痛发作减少,疲劳明显改善。使用拟交感神经胺六个月后,她注意到进行日常活动的能力有所改善,发作减少,精力增加。

结论

如本病例报告所示,当类风湿关节炎的传统疗法无效时,拟交感神经胺可有效缓解关节疼痛,至少在水负荷试验异常时如此。也许这种疗法在抑制可导致胎儿死亡的绒毛膜羊膜炎方面可能被证明是有益的。

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