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患儿,男,9个月,苏州人,半年来反复腹泻,近1周来加剧,于1986年5月30日入我院。大便多至每日10余次,呈蛋花样,有时见粘液血丝。为第1胎第1产,生后不久即见湿疹。自出生后1个月开始,半年多来因反复腹泻、发热及皮疹曾多次去其他医院就诊,诊断为小儿迁延性肠炎、婴儿湿疹。入院前一个月住某医院18天,诊断为“败血症”、“消化不良”、“营养不良”和血小板减少性紫癜。对青霉素过敏。其父有类风湿病,母体健,非近亲结婚。体检:T 38℃(肛),W 6.5 kg,精神差,呈脱水貌,面部及四肢有散在性湿疹,咽部充血,口腔内有少许苔状物,心肺听诊无异常,腹脂0.4 cm,肝肋下1 cm,脾未及,肠鸣音亢进。化验:Hb 8.6 g/dL,RBC 339万/μl,WBC 7800╱μl,N 45％,L 55％,BPC 6万～8万╱μl,尿常规无异常,尿培养阴性,
Children, male, 9 months, Suzhou, repeated diarrhea six months, nearly 1 week to aggravate, on May 30, 1986 into our hospital. Stool up to more than 10 times a day, was egg-shaped, and sometimes see mucus bloodshot eyes. For the first child of the first production, see eczema soon after birth. Since one month after birth, more than six months due to repeated diarrhea, fever and skin rashes have repeatedly go to other hospitals, diagnosed as childhood protracted enteritis, eczema in infants. A hospital a month before admission to a hospital for 18 days, diagnosed as “sepsis”, “indigestion,” “malnutrition,” and thrombocytopenic purpura. Allergic to penicillin. His father is rheumatoid, maternal health, non-relatives get married. Physical examination: T38 ℃ (anus), W 6.5 kg, poor spirit, was dehydrated, scattered eczema on the face and limbs, throat congestion, a little moss in the mouth, no abnormal heart and lung auscultation, abdominal fat 0.4 cm, Liver ribs 1 cm, spleen and bowel sounds hyperactivity. Laboratory: Hb 8.6 g / dL, RBC 339 万 / μl, WBC 7800 ╱ μl, N 45%, L 55%, BPC 60000 ~ 80 000 ╱ μl, urine no abnormalities, urine culture negative,