Brinkman Antonia, Schneider Udo, Buttgereit Frank, Burmester Gerd, Krusche Martin
Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Deutschland.
Z Rheumatol. 2021 Mar;80(2):180-183. doi: 10.1007/s00393-020-00921-0. Epub 2020 Nov 16.
We report the case of a 42-year-old male patient with acute onset of asymmetrical polyarthritis of the medium and large joints as well as fever and elevated serological inflammation markers. The symptoms began shortly after initiation of thiamazole treatment for newly diagnosed Graves' disease. Antithyroid arthritis syndrome (AAS) is a rare but serious adverse side effect of antithyroid treatment with thioamides such as thiamazole. Clinically, AAS may present with myalgia, arthralgia, fever, exanthema and polyarthritis. In the case of suspected AAS, when possible the thionamide medication should be rapidly discontinued or modified in consultation with the endocrinologist. In some cases anti-inflammatory therapy with NSAID or corticosteroids may be required for symptom control.
我们报告了一例42岁男性患者,该患者出现中、大关节不对称性多关节炎急性发作,伴有发热及血清学炎症标志物升高。症状在开始使用甲巯咪唑治疗新诊断的格雷夫斯病后不久出现。抗甲状腺关节炎综合征(AAS)是使用硫代酰胺类如甲巯咪唑进行抗甲状腺治疗罕见但严重的不良副作用。临床上,AAS可能表现为肌痛、关节痛、发热、皮疹和多关节炎。对于疑似AAS的病例,如有可能,应与内分泌科医生协商后迅速停用或调整硫代酰胺类药物。在某些情况下,可能需要使用非甾体抗炎药或皮质类固醇进行抗炎治疗以控制症状。