患儿,女,5岁,农村儿童,因反复面色苍黄2年,加重1个月入院。2年前病儿面色渐黄,厌食、乏力,喜食“烟蒂、茶叶”,无发热,无吐泻,无皮疹及关节疼痛,就诊当地医院诊为“缺铁性贫血”,给予铁剂治疗,症状缓解。但病儿体质虚弱,常有发热、咳嗽等症状,在当地医院考虑:上呼吸道感染、支气管炎,经抗菌素治疗症状控制。病儿面黄无进行性加重,血红蛋白波动于40～90g/L,未予恃殊治疗。1个月前病儿面黄加重,伴发热、咳嗽,无咯血,血红蛋白降至25g/L,入当地医院作骼穿示:“增生性骨髓像”,给予输血等对症处理,诊断未明。遂入我院治疗。入院查体:T38℃,重度贫血貌,咽红,颈部可触及数个肿大的淋巴结,黄豆大小,质软,无触痛。肝 Children, women, 5 years old, rural children, due to repeated pale yellow 2 years, increased 1 month admission. 2 years ago, the sick child turned yellow, anorexia, fatigue, eat “Cigarette, tea”, no fever, no vomiting, no rash and joint pain, visit the local hospital diagnosed as “iron deficiency anemia”, given iron treatment, Symptoms are relieved. However, sick children physical weakness, often fever, cough and other symptoms, considered in the local hospital: upper respiratory tract infection, bronchitis, antibiotic treatment of symptoms control. Children with yellow non-progressive aggravating hemoglobin fluctuations in 40 ~ 90g / L, no special treatment. A month ago, the sick child had yellowing, accompanied by fever, cough, hemoptysis, hemoglobin dropped to 25g / L into the local hospital for illusion: “hyperplastic bone marrow like” to give symptomatic treatment such as blood transfusion, the diagnosis is unknown. Then into our hospital for treatment. Admission examination: T38 ℃, severe anemia appearance, throat, the neck can reach several swollen lymph nodes, soy size, soft, no tenderness. liver