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作者报告一例50岁男性患者,因发热、咽痛数日后有严重关节炎、全身红斑疹、肉眼血尿与尿少,诊断为“风湿热”。9年后再次出现上述症状,并有高血压与氮质血症,尿中有红细胞管型。4星期内病情自动缓解,8个月后再次发作时无尿且病情危笃。血化验:钠123毫当量/升,CO_2总量5.4毫当量/升,血尿素氮164毫克/100毫升,肌酐11.6毫克/100毫升,磷8.2毫克/100毫升,pH7.25,尿有蛋白及红、白细胞和红细胞管型。经腹膜透析后缓解。4个月后复发,咽培养25次均阴性。β_1C球蛋白稍低,用青霉素预防无效,以后仍有三次发作。换用强的松与硫唑嘌呤,病情亦两度恶化。总共复发5次后发生肾病综合征,每日尿蛋白6～10克。
The authors report a 50-year-old male diagnosed with “rheumatic fever” because of severe arthritis, generalized red blood corpus, gross hematuria and oliguria few days after a sore throat. 9 years after the above symptoms again, and high blood pressure and azotemia, red blood cells in urine. The condition was relieved within 4 weeks and anuria and ailments were not seen again after 8 months. Blood tests: sodium 123 meq / l, CO 2 total 5.4 meq / l, blood urea nitrogen 164 mg / 100 ml, creatinine 11.6 mg / 100 ml, phosphorus 8.2 mg / 100 ml, pH7.25, urine protein and Red, white blood cells and red blood cell tube type. Peritoneal dialysis after remission. Recurrence after 4 months, pharyngeal culture 25 times were negative. β_1C globulin slightly lower, with penicillin to prevent invalid, there are still three episodes later. For prednisone and azathioprine, the condition also deteriorated twice. A total of 5 relapse after nephrotic syndrome, urinary protein 6 to 10 grams daily.