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患者,女,16岁。因上呼吸道感染后鼻衄在外院查骨髓象:“原始粒细胞2.5％”,拟诊为“骨髓增生异常综合征难治性贫血型”,给予维甲酸20mg,Bid,七天后出现剧烈头痛,双眼复视,转入我院。体检:T 36.8℃,P 76次/分,R18次/分,BP12/9kPa,轻度贫血貌。皮肤粘膜无瘀点瘀斑黄染。浅表淋巴结未肿大。双侧瞳孔等大等圆,对光反射存在。双眼球活动自如,鼻腔牙龈来见渗血,咽不红,扁桃体不大,伸舌居中。心、肺、腹部体征无异常,四肢肌力、肌张力正常,指鼻试验,跟膝胫试验阴性,病理反射未引出,颈软,克氏征(-),布氏征(-)。辅助检查:血WBC 5.6×10~9/L,Hb 93g/L,PLT 86×10~9/
Patient, female, 16 years old. Due to upper respiratory tract infection after epistaxis check the bone marrow in the outer hospital: “primitive granulocyte 2.5%”, to be diagnosed as “myelodysplastic syndrome refractory anemia”, given retinoic acid 20mg, Bid, severe headache after seven days, Binocular diplopia, transferred to our hospital. Physical examination: T 36.8 ℃, P 76 beats / min, R 18 beats / min, BP 12 / 9kPa, mild anemia appearance. Skin mucosa petechia ecchymosis. Superficial lymph nodes are not enlarged. Big pupils and other bilateral round, the presence of light reflex. Eyes easy to move, see the nose and gingival see oozing, pharynx is not red, tonsil, extension tongue center. Heart, lung, abdominal signs were normal, limb muscle strength, muscle tone normal, finger nose test, knee negative with knee test, pathological reflex did not lead to neck soft, Kirschner sign (-), Brinell’s sign (-). Auxiliary examination: blood WBC 5.6 × 10 ~ 9 / L, Hb 93g / L, PLT 86 × 10 ~ 9 /