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患者,女,59岁。因反复鼻衄,皮下淤斑20年,加重伴头晕、纳差、腹胀月余入院。患者20年来曾因“血小板减少性紫癜”、“慢性肾盂肾炎”在多家医院住院治疗数次。查体:左侧鼻腔出血,口周、唇、舌尖、颊粘膜及双手、足等处可见多发褐色色素斑,口唇处色素斑密集融合成片,不高于皮肤粘膜表面,压之褪色(患者自述色素斑出现已近40年,近年来较前加深)。右臂及右臀部可见大片皮下淤斑。上腹中部压痛,脾肋下1cm,轻微触痛,双肾区轻叩痛。
Patient, female, 59 years old. Due to repeated epistaxis, subdural ecchymosis 20 years, aggravated with dizziness, anorexia, abdominal distension more than month admitted. Over 20 years, patients have been hospitalized several times for “thrombocytopenic purpura” and “chronic pyelonephritis.” Examination: the left nasal bleeding, perioral, lip, tongue, buccal mucosa and hands, feet and other places can be found in multiple brown pigmented spots, the lips pigment spots intensive fusion into a film, not higher than the skin mucosal surface, the pressure of fading Self-described pigment spots appear nearly 40 years, deepened in recent years). Right arm and right hips visible large subcutaneous ecchymosis. Upper abdominal tenderness, spleen ribs 1cm, a slight tenderness, kidney area light tapping pain.