Siebels M, Schulz V, Andrassy K
Medizinische Universitätsklinik Heidelberg.
Dtsch Med Wochenschr. 1995 Feb 17;120(7):214-8. doi: 10.1055/s-2008-1055336.
A 60-year-old stonemason, suffering for many years from joint pains and exertional dyspnoea, developed a high fever with weight loss. Physical examination revealed reddening of light-exposed skin areas, fine rales and overly warm and reddened hand and knee joints. Abnormal laboratory findings were increased erythrocyte sedimentation rate of 66 mm/h, C-reactive protein concentration of 1 mg/dl, haemoglobin of 9.4 g/dl and white cell count of 3300/microliters. Urine contained albumin (100 mg/dl) and cylinders. Titres of both antinuclear and anti-ds-DNA antibodies were elevated (1:2560 and > 97 U/ml, respectively). The chest radiography showed enlarged hili, as well as reticular and nodular shadows which histologically showed silicosis. Systemic lupus erythematodes was diagnosed and the patient was treated with prednisone (2 mg/kg daily), the dosage being reduced to 12 mg daily within 3 months. When the joint pains recurred, azathioprine (50 mg daily) was added for 24 months. At present he is receiving prednisone (12 mg daily) and there has been no recurrence for 4 years.
一名60岁的石匠，多年来饱受关节疼痛和劳力性呼吸困难之苦，出现了高热并伴有体重减轻。体格检查发现暴露于光线的皮肤区域发红，有细湿啰音，手部和膝关节过度温暖且发红。实验室检查异常结果为红细胞沉降率增至66毫米/小时，C反应蛋白浓度为1毫克/分升，血红蛋白为9.4克/分升，白细胞计数为3300/微升。尿液中含有白蛋白（100毫克/分升）和管型。抗核抗体和抗双链DNA抗体的滴度均升高（分别为1:2560和>97单位/毫升）。胸部X线片显示肺门增大，以及网状和结节状阴影，组织学检查显示为矽肺。诊断为系统性红斑狼疮，患者接受泼尼松治疗（每日2毫克/千克），3个月内剂量减至每日12毫克。当关节疼痛复发时，加用硫唑嘌呤（每日50毫克），持续24个月。目前他正在接受泼尼松治疗（每日12毫克），4年来未再复发。
