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病例报导:患者,男,55岁。1983年9月因发热、乏力、食欲不振住院。体温38.7℃,黄疸,浅表淋巴结不肿大,肝脾大。血红蛋白(Hb)15.3g/dl,白细胞2500/cm,总胆红素(TB)6.4mg/dl,直接胆红素(DB)4.2mg/dl,乳酸脱氢酶9741U/L。抗感染治疗无效,发展为全血细胞减少。骨髓检查为骨髓增生异常综合征。改用强的松龙后热退。1984年6月再次发热,转肿瘤中心诊治。初次在该中心住院查体温39.9℃,营养不良,意识障碍,黄疸,肝肋下5cm,脾12cm。外周血涂片检出网织红细胞和幼红细胞增多。骨髓涂片见大量巨噬样细胞并吞噬血细胞和少数大型幼稚细胞。前后共8次Coombs直接、间接试验仅一次直接阳性,临
Case report: Patient, male, 55 years old. September 1983 due to fever, fatigue, loss of appetite hospitalized. Body temperature 38.7 ℃, jaundice, superficial lymph nodes are not enlarged, hepatosplenomegaly. Hemoglobin (Hb) 15.3g / dl, white blood cells 2500 / cm, total bilirubin (TB) 6.4mg / dl, direct bilirubin (DB) 4.2mg / dl, lactate dehydrogenase 9741U / Anti-infective therapy ineffective, the development of pancytopenia. Bone marrow examination for myelodysplastic syndrome. After the switch to prednisolone heat back. June 1984 fever again, turn the tumor center diagnosis and treatment. For the first time in the center of the hospital check body temperature 39.9 ℃, malnutrition, disturbance of consciousness, jaundice, hepatic ribs 5cm, spleen 12cm. Peripheral blood smear detected reticulocytes and erythroblasts increased. See a large number of bone marrow smear-like macrophages and phagocytosis of blood cells and a small number of large naive cells. Before and after a total of 8 times Coombs direct, indirect test only once directly positive, Pro