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过敏性紫癜及血小板减少性紫癜临床上较常见,而良性高丙球蛋白血症性紫癜则罕见,现报告一例如下。病例报告林××,女,33岁,住院号11300。因头晕两个月,多次昏倒,于1979年6月4日入院。缘于1979年4月2日分娩第4胎,因产后大出血急诊入当地公社医院,经治疗4天出院。后因头晕、腹胀及下肢浮肿,于4月25日再次住公社医院。当时查腹水征(+),双下肢浮肿;检肝功能异常,诊为“肝硬化”,经治疗18天,腹水征消失,好转出院。本次入院前三天,患者每天昏倒2～3次,每次约半小时,可自行恢复,以昏倒原因不明入我院。既往尚健,近4年发现肢体时有散在瘀点。入院体检;慢性病容,贫血外观,表情淡漠。T 37.4℃,p 84次/分,Bp110/80mmHg。皮肤巩膜未见黄染,全身浅表淋巴结无肿大。颈软,甲状腺无肿大。肺(-)。心尖区及肺动脉瓣区可闻及Ⅱ°收缩期吹风样杂音,早搏15次/分。腹平软,肝脾未触及,腹水征(-)。脊柱四肢无畸形。无腋毛,两上肢可见粟粒大小散在出血点,两下肢有明显色素沉着,呈暗褐色。神经系检查(-)。妇科检查:阴毛稀少,余无特殊。
Anaphylactoid purpura and thrombocytopenic purpura clinical more common, and benign hypergammaglobulinemic purpura is rare, are reported as an example below. Case report Lin × ×, female, 33 years old, hospital number 11300. Due to dizziness for two months, many collapsed, on June 4, 1979 admission. Due to April 2, 1979 delivery of the first 4 births, emergency postpartum hemorrhage into the local commune hospital, the treatment was discharged 4 days. After due to dizziness, abdominal distension and lower limb edema, on April 25 once again live in the commune hospital. At that time, check ascites (+), both lower extremities edema; check liver dysfunction, diagnosed as “cirrhosis”, after 18 days of treatment, signs of ascites disappeared, improved discharged. Three days before the admission, patients collapsed 2 to 3 times a day, each about half an hour, can be self-healing, to faint reasons unknown to our hospital. Past healthy, nearly 4 years found that there are scattered stasis limbs. Admission examination; Chronic disease, anemia appearance, expression of indifference. T 37.4 ° C, p 84 bpm, Bp 110/80 mmHg. Skin sclera no yellow dye, systemic superficial lymph nodes without swelling. Neck soft, no swelling of the thyroid. lung(-). Apex and pulmonary valve area can be heard and Ⅱ ° systolic hair-like noise, premature beats 15 beats / min. Abdomen soft, liver and spleen not touched, signs of ascites (-). Spine limbs without deformity. No armpit hair, two upper limbs visible miliary size scattered bleeding point, two lower extremities obvious pigmentation, dark brown. Neurological examination (-). Gynecological examination: pubic hair scarce, I no special.