Nishinarita M, Nameki H, Saito Y, Kashiwazaki S
Department of Internal Medicine, Hitachi General Hospital, Ibaraki.
Ryumachi. 1991 Aug;31(4):405-12.
A 62-year-old woman, who had suffered from putsulosis palmaris et plantaris for about two years, was admitted to our hospital due to lumbago, sweating and palpitation. On the basis of physical and endocrinological examinations, she was diagnosed as Basedow's disease. X-ray findings revealed ossification in the left costo-clavicular joints, and characteristic syndesmophytes of PAO in vertebral bodies. These lesions were followed by high accumulation of 99mTc in bone scintigrams. PAO is considered to be in a category of seronegative spondylarthropathy or rheumatic disease. Previous reports of PAO accompanied with autoimmune diseases are few. The association of PAO and Basedow's disease has not been reported. As PAO in this case was refractory to conventional therapies, low-dose MTX pulse therapy(oral 7.5mg/day administration on every week) was initiated. MTX markedly improved both putsulotic palmaris et plantalis and PAO.
一名62岁女性，患掌跖脓疱病约两年，因腰痛、多汗和心悸入院。经体格检查和内分泌检查，诊断为突眼性甲状腺肿。X线检查发现左肋锁关节骨化，椎体有强直性脊柱炎的特征性韧带骨赘。骨闪烁显像显示这些病变部位有99mTc高度聚集。强直性脊柱炎被认为属于血清阴性脊柱关节病或风湿性疾病范畴。以往关于强直性脊柱炎伴发自身免疫性疾病的报道较少。强直性脊柱炎与突眼性甲状腺肿的关联尚未见报道。由于该病例的强直性脊柱炎对传统治疗无效，遂开始低剂量甲氨蝶呤脉冲疗法（每周口服7.5mg/天）。甲氨蝶呤使掌跖脓疱病和强直性脊柱炎均明显改善。
