University Medicine Cluster, Division of Rheumatology, National University Hospital, National University Health System, Singapore.
University Medicine Cluster, Division of Rheumatology, National University Hospital, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Chest. 2018 Nov;154(5):e127-e134. doi: 10.1016/j.chest.2018.07.026.
A 67-year-old retired air force officer presented with a 6-month history of nonproductive cough, progressive exertional dyspnea, and weight loss. He was unable to walk beyond 100 m compared with his baseline of unlimited walking distance. He denied fever, hemoptysis, myalgia, or chest pain. He had a 30-year history of chronic plaque psoriasis with arthritis, which was managed by his dermatologist with emollients and vitamin D analogues. Joint involvement had previously been controlled with methotrexate, which was discontinued 15 years ago after resolution of his symptoms. He developed a polyarthritis flare a year ago, and adalimumab was initiated with good response.
一位 67 岁的退休空军军官出现了 6 个月的无痰咳嗽、进行性劳力性呼吸困难和体重减轻。与他之前无限制行走距离的基线相比，他只能行走 100 米以内。他否认发热、咯血、肌肉痛或胸痛。他有 30 年的慢性斑块状银屑病伴关节炎病史，由皮肤科医生通过保湿剂和维生素 D 类似物进行治疗。关节受累以前曾通过甲氨蝶呤得到控制，15 年前在症状缓解后停用。一年前他出现了多发性关节炎发作，使用阿达木单抗治疗后反应良好。
