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患者男性,24岁,1987年4月因头颅外伤在外院行右侧颅内血肿清除术,术后一般情况好。术后两月困偶有“外伤性癫痫发作”,口服卡马西平,每次0.2g,一日三次,服药4天后停药。入院前10天再次口服卡马西平,每次0.2g,一日三次。用药4天后无诱因高热、寒战,尿频、尿急伴恶心、呕吐,1987年9月23日入院。查:体温39.5℃,咽部充血,颌下淋巴结肿大,心肺(一),肝于肋下2.0cm,脾未触及。实验室检查:血像:血红蛋白60g/L;血小板210×10~9/L;白细胞10.5×1O~9/L,白细胞分类:未见中性粒细胞,均为淋巴细胞。骨髓像:骨髓增生活跃,粒红比例0.003:1;计数500个有核细胞,粒系几乎绝迹,仅见到一个早幼粒细胞。组化染色:PAS幼红细胞(一),糖水试验阴性,肾上腺素试验阴性,肝功:单项转氨酶增高;
Male patient, 24 years old, in April 1987 due to craniocerebral injury in the right lateral cerebral hematoma removal surgery, postoperative general condition is good. After two months of sleepy even “traumatic seizures”, oral carbamazepine, each 0.2g, three times a day, medication after 4 days withdrawal. 10 days before admission oral carbamazepine, each 0.2g, three times a day. 4 days after treatment no incentive fever, chills, frequent urination, urgency with nausea, vomiting, September 23, 1987 admission. Check: body temperature 39.5 ℃, throat congestion, submandibular lymph nodes, heart and lung (a), the liver in the ribs 2.0cm, spleen not touched. Laboratory tests: blood: hemoglobin 60g / L; platelets 210 × 10 ~ 9 / L; white blood cells 10.5 × 10 ~ 9 / L, white blood cell classification: no neutrophils, are lymphocytes. Bone marrow like: bone marrow hyperplasia active, the proportion of the grainy 0.003: 1; counting 500 nucleated cells, almost completely disappeared, only to see a promyelocytic. Histochemical staining: PAS erythrocytes (a), negative sugar test, negative adrenaline test, liver function: single transaminase increased;