Chouk Mickaël, Vidon Claire, Deveza Elise, Verhoeven Frank, Pelletier Fabien, Prati Clément, Wendling Daniel
Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Department of Dermatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Joint Bone Spine. 2017 Jan;84(1):83-85. doi: 10.1016/j.jbspin.2016.05.001. Epub 2016 Jun 3.
Intravenous drug addiction is responsible for many complications, especially cutaneous and infectious. There is a syndrome, rarely observed in rheumatology, resulting in "puffy hands": the puffy hand syndrome. We report two cases of this condition from our rheumatologic consultation. Our two patients had intravenous drug addiction. They presented with an edema of the hands, bilateral, painless, no pitting, occurring in one of our patient during heroin intoxication, and in the other 2 years after stopping injections. In our two patients, additional investigations (biological, radiological, ultrasound) were unremarkable, which helped us, in the context, to put the diagnosis of puffy hand syndrome. The pathophysiology, still unclear, is based in part on a lymphatic toxicity of drugs and their excipients. There is no etiological treatment but elastic compression by night has improved edema of the hands in one of our patients.
静脉药物成瘾会引发许多并发症，尤其是皮肤和感染方面的并发症。有一种综合征，在风湿病学中很少见，会导致“手部肿胀”：即手部肿胀综合征。我们报告了两例来自我们风湿科会诊的这种病症。我们的两名患者都有静脉药物成瘾史。他们均出现双手水肿，双侧性、无痛、无凹陷，其中一名患者在海洛因中毒期间出现，另一名患者在停止注射两年后出现。在我们的两名患者中，进一步检查（生物学、放射学、超声）均无异常，这有助于我们在此背景下做出手部肿胀综合征的诊断。其病理生理学仍不清楚，部分基于药物及其辅料的淋巴毒性。目前尚无病因治疗方法，但夜间使用弹力压迫已使我们其中一名患者的手部水肿有所改善。
