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患者男性,16岁,学生。因腹痛半月,加重伴四肢紫癜及黑便1周于1992年2月20日入院。半月前出现无明显诱因的腹部阵发性绞痛,1周后四肢出现紫癜伴黑便。当地医院对症处理无效后转来我科。否认起病前有“上感”及服药史。体检:T37.5℃,精神软,面色萎黄,心肺听诊正常,腹软略膨,全腹压痛,无反跳痛,移动性浊音可疑,肝脾肋下未及,关节无红肿。皮肤科检查:四肢远端仲侧为主对称性稀疏黯红色紫癜,不高出皮面,束臂试验阳性。实验室检查:血常规、血小板、血沉、出血时间、凝血时间、凝血因子、IgA、IgG、IgM、补体C_3、肾功能均在正常范围,尿蛋白++,红细胞++,大便潜血(?)。
Patient male, 16 years old, student. Due to abdominal pain and a half months, exacerbations with purpura limbs and black one week in February 20, 1992 admission. Half a month before there was no obvious incentive for paroxysmal abdominal cramps, purpura associated with black stool after one week limbs. Local hospital symptomatic treatment invalid transfer to our department. Denied before the onset of “flu” and medication history. Physical examination: T37.5 ℃, the spirit of soft, pale complexion, cardiopulmonary auscultation normal, slightly soft bulging abdomen, the whole abdominal tenderness, no rebound pain, mobility dull suspicious, liver and spleen ribs, joint swelling. Dermatology examination: the distal limbs of the main side of the symmetry sparse dark red Purpura, not higher than the skin, beam arm test positive. Laboratory tests showed that blood routine, platelet, erythrocyte sedimentation rate, bleeding time, clotting time, clotting factor, IgA, IgG, IgM, complement C_3 and renal function were in the normal range. Urinary protein ++, erythrocyte ++, .