Dexamethasone

医脉通-临床病例平台 医脉通临床病例平台，为医生保留的病例交流线上站，快来一起讨论，共同学习。 病史摘要 现病史：患者入院5个月前无明显诱因下出现双下肢无力伴凹陷性水肿，当时患者无发热、体重减轻，有泡沫尿。患者4个月前至当地医院就诊，实验室检查发现患者有蛋白尿，当地医院诊断“肾炎”，予以螺内酯及抗炎治疗，水肿好转。3个月前患者因下肢反复水肿，在当地接受中医治疗，水肿略有好转，利尿药物间歇性服用。1个月前患者再度出现水肿加重，当地医院诊断为甲减，予以地塞米松和左甲状腺素治疗，并转入当地三甲医院。此时患者出现肢端麻木伴视物模糊，查骨髓穿刺（结果不详），血清免疫固定电泳发现M蛋白，予以呋塞米及人血白蛋白对症治疗，水肿消退不明显，并出现大量腹水。为进一步明确诊断和治疗转诊我院，收入病房。 入院查体 神清，精神可，皮肤、黏膜无黄染、苍白，未见瘀斑、瘀点，皮肤色素沉着，呈暗黑色，杵状指，白甲。颈部可及淋巴结数个，大小约0.8cm×1.0cm ，可活动，光滑，无压痛。双肺呼吸音清，未闻及干、湿啰音，两下肺呼吸音低。心律齐，心率80次/分。腹软，无压痛、反跳痛，肝肋下刚及，脾肋下2指，腹水征(±)。上下肢末端触觉稍减退，腱反射正常，双下肢凹陷性水肿。 辅助检查 （1）血常规：白细胞5.8×10⁹/L ，血红蛋白 135g/L ，血小板 292×10⁹/L。 （2）肝肾功能：肝功能正常，ALB26 - 28g/L ；肾功能示肌酐明显升高245 - 375μmol/L。 （3）甲状腺功能：甲状腺球蛋白11.07ng/ml，三碘甲状腺原氨酸0.7 nmol/L，甲状腺素50.13nmol/L 。 （4）内分泌激素：促肾上腺皮质激素80.8IU/L；睾酮3.6nmol/L 。 （5）免疫指标：ANA、Ig全套、ANCA、 RF 、ds-DNA均阴性。 （6）血免疫固定电泳：血清中检出 M 蛋白，为IgG-λ型。 （7）肿瘤指标：CA125 90.7U/ml 。 （8)B超：① 胆囊结石，胆囊炎；② 脾大；③ 腹盆腔积液；④ 双下肢动脉斑块形成。 （9）心超：①肺动脉高压65mmHg；② 右心室肥大伴三尖瓣关闭不全；③少量心包积液。 患者入院后进一步完善以下检查： （1）胸部CT：①双侧胸腔及心包腔积液；②纵隔多发中心小型淋巴结；③两肺门影增大。 （2）腹部CT：①双侧胸腔及心包腔积液，少量腹水。②CT平扫肝实质未见明显异常密度阴影；肝脏增大，形态饱满；脾大。 （3）头颅MRI：①头颅MRI平扫脑实质内未见明显异常信号；②副鼻窦炎；③颅骨信号减低；④垂体未见明显异常信号。 （4）骨髓涂片：骨髓增生活跃，粒红比例正常。粒系增生活跃，可见嗜酸嗜碱粒细胞。涂片中浆细胞可见1.5％。 （5）肌电图：①双侧腓神经较重度受损，双侧正中神经尺神经轻中度受损；②双侧腓神经F波未引出，双侧正中神经F波延迟；③双侧三角肌、肱二头肌时限稍短。 欢迎讨论 说说你的诊断，并谈谈该疾病的诊断标准。 （查看原文参与互动讨论  ，正确进行麦粒奖励） 审校：ZTL 排版：Atai 执行：Atai END 点击 [阅读原文] 进入原病例参与讨论，您的临床思考将为医学实践注入更多鲜活洞见！

[8-22-2025] The Food and Drug Administration is advising consumers not to purchase or use PAIN FLEX, a product promoted and sold for joint pain on various websites, including Amazon.com and possibly in some retail stores. FDA laboratory analysis confirmed that PAIN FLEX contains dexamethasone and methocarbamol not listed on the product label. Dexamethasone is a corticosteroid commonly used to treat inflammatory conditions. Corticosteroid use can impair a person’s ability to fight infections and can cause high blood sugar levels, muscle injuries and psychiatric problems. When corticosteroids are taken for a prolonged period or at high doses, they can suppress the adrenal gland. Abrupt discontinuation can cause withdrawal symptoms. Additionally, the undeclared dexamethasone may cause serious side effects when combined with other medications. Consumers taking PAIN FLEX should immediately consult with their health care professional to safely discontinue use of this product. The risks of withdrawal from corticosteroids should be assessed by a health care professional. Only licensed health care professionals can evaluate patients for the risk or existence of adrenal suppression. Methocarbamol is a muscle relaxant that can cause sedation, dizziness and low blood pressure. Methocarbamol also can impair mental and physical abilities to perform certain tasks, such as driving a motor vehicle or operating machinery. Health care professionals and consumers should report adverse events or side effects related to the use of this product to FDA’s MedWatch Safety Information and Adverse Event Reporting Program: This notification is to inform the public of products potentially marketed as dietary supplements or conventional foods with hidden drug ingredients and chemicals. These products are typically promoted for sexual enhancement, weight loss, pain relief and body building and are often represented as being all natural. Consumers should exercise caution before purchasing these products. FDA is unable to test and identify all products marketed as dietary supplements that have potentially harmful hidden ingredients. For more information: Content current as of: 08/26/2025 Legal Disclaimer: EIN Presswire provides this news content "as is" without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.