Uthman I, Senécal J L
Division of Rheumatology, Hôpital Notre-Dame, Montréal, Canada.
J Rheumatol. 1995 Oct;22(10):1964-6.
We describe a patient with Cushing's disease who, shortly after trans-sphenoidal surgical resection of an adrenocorticotropic hormone secreting pituitary microadenoma and specifically at the time of normalization of her serum cortisol level, developed a subacute episode of symmetric polyarticular synovitis. This episode lasted for one month; however, it did not resolve completely and progressed after 3.5 years of diffuse arthralgias and morning stiffness to seropositive and erosive rheumatoid arthritis (RA). Review of the literature revealed 3 additional patients with RA with a similar course. These patients may represent a natural illustration of the antiinflammatory effects of supraphysiological levels of endogenous glucocorticoids.
我们描述了一名库欣病患者，在经蝶窦手术切除分泌促肾上腺皮质激素的垂体微腺瘤后不久，特别是在其血清皮质醇水平恢复正常时，出现了对称性多关节滑膜炎的亚急性发作。该发作持续了一个月；然而，它并未完全缓解，在3.5年的弥漫性关节痛和晨僵后进展为血清阳性和侵蚀性类风湿关节炎（RA）。文献回顾发现另外3例RA患者病程相似。这些患者可能是内源性糖皮质激素超生理水平抗炎作用的自然例证。
