General Internal Medicine, East Surrey Hospital, Redhill, UK
General Internal Medicine, East Surrey Hospital, Redhill, UK.
BMJ Case Rep. 2021 Dec 31;14(12):e246187. doi: 10.1136/bcr-2021-246187.
We present here an interesting case of a 67-year-old man with 3 weeks history of lethargy, loss of appetite, generalised weakness and weight loss. Following thorough investigations, occult malignancy was ruled out. Hyponatraemia was a consistent finding which needed further classification. Additional workup including cerebral imaging and neurophysiological studies excluded cerebral vascular events and myopathies. Vasculitis screening was undertaken, and the diagnostic dilemma was revealed by the temporal arteries Doppler ultrasound which showed classical 'halo sign'. Diagnosis of temporal arteritis was made and linked with syndrome of inappropriate antidiuretic hormone secretion, which appears to be a rare association with few instances on record. Patient was treated with high dose of prednisolone with marked improvement of clinical features.
我们在此呈现一例有趣的病例，一名 67 岁男性，3 周来出现乏力、食欲不振、全身无力和体重减轻。经过全面检查，排除了隐匿性恶性肿瘤。低钠血症是一个持续存在的发现，需要进一步分类。包括脑影像学和神经生理学研究在内的其他检查排除了脑血管事件和肌病。进行了血管炎筛查，颞动脉多普勒超声显示出经典的“晕环征”，从而揭示了诊断上的困境。诊断为颞动脉炎，并与抗利尿激素分泌不当综合征相关，这种关联似乎很少见，仅有少数病例记录。患者接受了大剂量泼尼松龙治疗，临床症状明显改善。
