Hill C, Pile K, Henderson D, Kirkham B
Rheumatology Unit, Queen Elizabeth Hospital, Woodville, Australia.
Br J Rheumatol. 1995 Oct;34(10):989-90. doi: 10.1093/rheumatology/34.10.989.
We describe two patients who developed neurological side effects as part of the spectrum of nitritoid reactions. Both reactions occurred late in the course of treatment. The first patient developed mild nitritoid symptoms and pain in a band-like distribution, corresponding to T10-T12 dermatomes, shortly after gold sodium thiomalate (GSTM) injection. Further injections were followed by similar symptoms in addition to paraesthesiae and altered pin-prick sensation of anterior thigh and legs with no residual deficit. She has had no further episodes since substitution of aurothioglucose. The second patient experienced mild nitritoid symptoms following several GSTM injections prior experiencing a cerebrovascular accident within several hours of her next injection. She subsequently haemorrhaged into the infarcted area with residual neurological deficits. These cases highlight that nitritoid reactions can be severe and may be heralded by milder symptoms. Patients who develop these reactions whilst receiving GSTM can be successfully changed to aurothioglucose.
我们描述了两名出现神经学副作用的患者，这些副作用属于类亚硝酸盐反应谱的一部分。两种反应均发生在治疗过程后期。首例患者在注射硫代苹果酸金钠（GSTM）后不久，出现轻度类亚硝酸盐症状以及带状分布的疼痛，对应于T10 - T12皮节。后续注射除了感觉异常以及大腿前部和腿部针刺感觉改变外，还出现类似症状，且无残留缺陷。自改用硫代葡萄糖金后，她未再出现发作。第二例患者在多次注射GSTM后出现轻度类亚硝酸盐症状，随后在下次注射后数小时内发生脑血管意外。她随后在梗死区域出血，遗留神经功能缺损。这些病例凸显出类亚硝酸盐反应可能很严重，且可能先出现较轻症状。接受GSTM治疗时出现这些反应的患者改用硫代葡萄糖金可取得成功。
