摘要
报道1例双侧小腿巨大液态痛风石病例。患者男性41岁,具有10余年痛风病史。患者有高脂血症和糖尿病前期,以及怀疑患者长期使用皮质醇激素类药物。经过规范降尿酸、降血脂、纠正糖耐异常等治疗,半年间体重下降了12 kg,发现双侧小腿对称性肿大入院。超声检查显示肿块位于腓肠肌后皮下,左小腿肿块大小约14.9 cm×6.7 cm,右小腿肿块约13.6 cm×4.6 cm,边界清楚。依据临床表现及实验室检查确定双侧小腿肿块为痛风石。经超声引导下对肿块穿刺引流,从双侧小腿皮下肿物中均抽出约200 mL液体。继续规范降尿酸治疗后,患者病情好转。对于这种非典型巨大液态痛风石,临床医师要提高警惕,与肿瘤、感染、自身免疫性疾病等鉴别诊断,及时穿刺进行病理学检查。明确诊断后,可采取手术切除的同时规范降尿酸治疗,以期取得良好的预后。
A case of giant liquid tophus in both lower legs was reported.The patient was a 41-year-old man with a history of gout for more than 10 years.The patient had hyperlipidemia and prediabetes,and the long-term use of hormone cortisol drugs was suspected.After standardized treatment for lowering uric acid,reducing blood lipids,and correcting glucose intolerance,the patient lost 12 kg over six months.The patient was admitted to the hospital upon discovering symmetrical enlargement of both calves.Ultrasound showed subcutaneous masses with clear boundaries behind the gastrocnemius muscle,approximately 14.9 cm×6.7 cm on the left and 13.6 cm×4.6 cm on the right.Based on the clinical information and morphological features,a diagnosis of gouty tophus was made.Following ultrasound-guided puncture drainage,aspirate about 200 mL fluid from the subcutaneous masses of each lower legs.The patient continued to receive standardized uric acid-lowering treatment and the patient′s condition improved.For such atypical giant liquid tophus,clinical practitioners should remain vigilant,differentiating them from tumors,infections,autoimmune diseases,and promptly perform pathological examinations through puncture to be diagnosed.After a definitive diagnosis,surgical excision can be performed concurrently with standardized uric acid-lowering treatment to achieve a favorable prognosis.
作者
宋紫冰
刘朵朵
申婷婷
王从容
Song Zibing;Liu Duoduo;Shen Tingting;Wang Congrong(Department of Medical Laboratory,Zengcheng Hospital District,Nanfang Hospital of Southern Medical University,Guangzhou 511358,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2024年第9期789-792,共4页
Chinese Journal of Endocrinology and Metabolism
