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患儿,男,5岁,因皮肤出血点、血尿3天入院。入院前7天因着凉后发热、咳嗽,在当地治疗(用药不详)2天热退,咳止。其后因碰伤头部出现淤斑,并发现全身皮肤散在出血点,血尿呈全程均匀一致,无尿频、尿急和尿痛。家族史无特殊。体检:面色苍白,周身皮肤散在出血点及淤斑,以面部和躯干为著,心肺正常,肝在右肋下1.5cm,无触痛,脾在左肋下1.5cm。血红蛋白110克/L,血小板30×10~9/L,白细胞20×10~9/L 中性0.88,淋巴0.12,出血时间4分,凝血时间1分,网织红0.5。尿蛋白(++),红细胞(+++)。骨髓涂片有核细胞增生明显活跃,粒细胞系中性、杆状,分叶核为
Children, male, 5 years old, due to skin bleeding, hematuria 3 days admission. 7 days before admission due to cold after the fever, cough, in the local treatment (medication unknown) 2 days fever, cough stop. Subsequent bruising due to head injury and found that the whole body scattered in the bleeding spots, hematuria was uniform throughout the whole, no urinary frequency, urgency and dysuria. No special family history. Physical examination: pale, whole body scattered in the bleeding spots and ecchymosis to the face and trunk, normal lung and heart, liver in the right rib 1.5cm, no tenderness, the spleen in the left rib 1.5cm. Hemoglobin 110 g / L, platelets 30 × 10 ~ 9 / L, white blood cells 20 × 10 ~ 9 / L neutral 0.88, lymphatic 0.12, bleeding time 4 minutes, clotting time 1 minute, reticulocyte 0.5. Urinary protein (++), red blood cells (+++). Bone marrow smear nucleus significantly hyperplasia, neutrophil cell line, rod-shaped, lobulated for