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女患,73岁,因全身乏力入院。体检:贫血貌,胸骨叩压痛。辅检:Hb50g/L,WBC80×10~9/L,血片发现幼稚细胞,血小板40×10~9/L。骨髓检查:骨髓增生极度活跃,原幼单核细胞占60%,POX呈弱阳性-阳性反应;糖原染色阳性并有细颗粒:非特异性脂酶染色阳性(NaF可抑制)。血清溶菌酶明显增多。诊断:急性单核细胞性白血病(M_5)、给予化疗用Ara-C100mg/d,强的松15mg tid连用6天,VCR与ADR在化疗第一天仅用一次。当Ara-C第三天用药后约半小时,患者发热(体温从36.2℃上升至38.4℃)伴荨麻
Female, 73 years old, admitted to hospital due to malaise. Physical examination: anemia appearance, chest tenderness. Auxiliary examination: Hb50g / L, WBC80 × 10 ~ 9 / L, blood cells found naive cells, platelets 40 × 10 ~ 9 / L. Bone marrow examination: Myeloid hyperplasia is extremely active, with 60% of naive monocytes, weakly positive-positive POX; glycogen-positive and fine granules: nonspecific lipase staining positive (NaF inhibition). Serum lysozyme increased significantly. Diagnosis: Acute monocytic leukemia (M_5), given chemotherapy with Ara-C100mg / d, prednisone 15mg tid for 6 days, VCR and ADR on the first day of chemotherapy only once. When Ara-C was administered for about half an hour after the third day of treatment, the patient became fever (body temperature rose from 36.2 ° C to 38.4 ° C) with nettle