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患儿男,13岁。多饮多尿1周,日出入量6～7升,伴消瘦,午后高热。1年半前因鼻衄、苍白,在当地两次骨穿诊为“再生障碍性贫血”,口服康力龙病情稳定。查体:营养欠佳,苍白,牙齿略松动伴疼痛,浅表淋巴结稍大。化验:血红蛋白108g/L,白细胞4.8×10~9/L,中性0.45,淋巴0.55,血小板18×10~9/L,网织红细胞0.005,红细胞偏大,偶见晚幼红及原始粒细胞。血清铁蛋白392μg/L,两次骨髓标本示:粒系
Children male, 13 years old. Drink more urine for 1 week, the daily volume of 6 to 7 liters, with weight loss, high fever in the afternoon. A year and a half ago due to epistaxis, pale, twice in the local bone diagnosis of “aplastic anemia,” oral Conrolon disease was stable. Physical examination: poor nutrition, pale, slightly loose teeth with pain, superficial lymph nodes slightly larger. Assay: Hemoglobin 108g / L, white blood cells 4.8 × 10 ~ 9 / L, neutral 0.45, lymphatic 0.55, platelets 18 × 10 ~ 9 / L, reticulocytes 0.005, red blood cells are too large, . Serum ferritin 392μg / L, two bone marrow samples showed: grain system