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首页> 外文期刊>Endocrine journal >Exacerbation of Rheumatoid Arthritis after Removal of Adrenal Adenoma in Cushing's Syndrome
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Exacerbation of Rheumatoid Arthritis after Removal of Adrenal Adenoma in Cushing's Syndrome

机译：在缓解肾上腺腺瘤中去除肾上腺腺瘤后的类风湿性关节炎

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References(6) Cited-By(15) A 46-year-old woman with rheumatoid arthritis had been on non-steroidal antiinflammatory agents for eighteen years until she developed cushingoid features and hypertension resistant to antihypertensive drugs. She had high plasma cortisol and 24h urinary 17-hydroxycorticosteroids (17HCS) which were not suppressed by 8mg dexamethasone per day for two days. The circadian rhythm of plasma cortisol was absent and plasma ACTH concentrations were suppressed before and after intravenous administration of CRH. Abdominal computed tomography demonstrated a tumor (3.0×3.0×2.3 cm) in the right adrenal gland and a 131I-6 β-19-nor-methylcholesterol scan revealed marked uptake on the same side. The patient underwent a right adrenalectomy and the diagnosis of a cortisol secreting benign adenoma was histologically confirmed. Blood pressure declined and cushingoid features regressed, but three months after the operation and while the patient was on replacement, she complained of pain on motion, marked tenderness and swelling of fingers, wrists, elbows, knees and foot joints, and had very high rheumatoid factors. Treatment with immunosuppressive drugs and oral and intraarticular administration of glucocorticoids were necessary to relieve the clinical symptoms of rheumatoid arthritis. In summary, we report a patient with rheumatoid arthritis and Cushing's syndrome due to an adrenal adenoma, in whom rheumatoid arthritis was exacerbated after curing the Cushing's syndrome. This suggests that it is imperative to follow the development and/or course of autoimmune diseases after the treatment of Cushing's syndrome.
机译：参考文献（6）引用（15）一名带有类风湿性关节炎的46岁女性在非甾体关节炎上持续了18岁，直到她开发了抑制抗高血压药物的Cushingoid特征和高血压。她有高血浆皮质醇和24h尿17-羟基皮质类固醇（17HC），每天不会被8mg地塞米松抑制两天。血浆皮质醇的昼夜节律是不存在的，并且在静脉内施用CRH之前和之后抑制了血浆actH浓度。腹部计算断层扫描在右侧肾上腺和131i-6β-19-NOR-甲基胆固醇扫描中显示出肿瘤（3.0×3.0×2.3cm），显示出在同一侧的标记摄取。患者接受了右肾内切除术和诊断皮质醇分泌良性腺瘤的诊断组织学证实。血压下降和胸部抑制功能，但操作后三个月，患者替代时，她抱怨疼痛，手指，手腕，肘部，膝盖和足部接头的痛苦和肿胀，并且具有非常高的类风湿因素。用免疫抑制药物和口服和口腔胃癌的治疗方法是为了缓解类风湿性关节炎的临床症状。总之，由于肾上腺腺瘤，我们报告了具有类风湿性关节炎和库孔的综合征的患者，在治疗缓冲的综合征后，类风湿性关节炎加剧。这表明在治疗缓冲综合征后，遵循自身免疫性疾病的发展和/或过程。

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