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患者,女性,36岁.因腹胀三月,发热二月入院.病初感上腹胀,纳差、乏力,继之发热,体温逐渐升高,最高达40℃,呈弛张热型,体重减轻8kg.在外院初诊为肺部感染给予抗生素治疗10天,又疑肺结核而给予抗痨治疗2周,最后按SLE治疗(强的松30mg/d,10余天),均无效.病情危重转我院.既往健康.体检:T39℃,P104次/分,R24次/分,,Bp12/8kPa,慢性病容,贫血貌,无黄疸及皮疹,浅表淋巴结不大,心肺未见异常,腹软,无压痛,肝剑下8cm,右肋下6cm,质中等,压痛明显,脾高度肿大,腹水(-).实验室检查:Hb84g/L,WBC2.6×10~9/L,N0.82,L0.18,PLT31×10~9/L,Ret7‰.;ALB24g/L,ALT22U/L,TB16mmol/L,AKP
Patients, females, aged 36. Due to bloating in March, febrile patients were admitted to hospital in February. 8kg. Initial diagnosis of pulmonary infection in the outpatient hospital for antibiotics for 10 days, suspected tuberculosis and anti-tuberculosis treatment for 2 weeks, and finally press SLE treatment (prednisone 30mg / d, more than 10 days), are invalid. Physical examination: T39 ℃, P104 beats / min, R24 beats / min, Bp12 / 8kPa, chronic disease, anemia appearance, no jaundice and skin rash, superficial lymph nodes, no abnormalities of heart and lung, abdomen soft, no Tenderness, liver under the sword 8cm, right rib 6cm, medium quality, tenderness, splenomegaly, ascites (-). Laboratory tests: Hb84g / L, WBC2.6 × 10 ~ 9 / L, N0.82, L0.18, PLT31 × 10 ~ 9 / L, Ret7 ‰; ALB24g / L, ALT22U / L, TB16mmol / L, AKP