患者女,58岁,因怕冷、肌肉酸痛2个月,颜面及双下肢水肿2周就诊。化验尿常规示潜血++,蛋白+,镜检红细胞6~8个/HP,尿蛋白定量0.18 g/d,以“肾炎”收入院。自发病以来,患者无纳差、肌无力、便秘、体重变化等。查体:体温36.7℃,脉搏58次/min,呼吸16次/min,血压110/80 mm Hg。声音略嘶哑,颜面部轻度水肿,甲状腺可触及蚕豆大小结节, Female patient, 58 years old, because of cold, muscle soreness 2 months, face and lower extremity edema 2 weeks treatment. Laboratory urinalysis showed occult blood ++, protein +, microscopic examination of 6-8 erythrocytes / HP, urine protein quantitation 0.18 g / d, with “nephritis” income hospital. Since onset, patients without anorexia, muscle weakness, constipation, weight changes and so on. Physical examination: body temperature 36.7 ℃, pulse 58 beats / min, breathing 16 times / min, blood pressure 110/80 mm Hg. A little hoarse voice, mild facial facial edema, thyroid can reach the size of nodules,