急性再生障碍性贫血并发浆细胞型类白血病反应1例报告

• 作 者: 田日赐
• 机 构: 湖南省华容县人民医院
• 出 处: 医师进修杂志
• 发表日期: 1989年09期
• 关键词: 类白血病反应 细胞型 血清蛋白电泳 网织红细胞 牙龈出血 重度贫血貌 巨核细胞 心尖区 肝大 再障

患者,男,62岁,住院号2284。因腹泻服用氯霉素6天后,鼻、牙龈出血十余天,于1980年4月8日入院。体查:T38.5℃,P110次。重度贫血貌:颈部淋巴结似黄豆大小;腹部见数个出血点。心界向左下扩大,心尖区可闻Ⅲ级收缩期吹风性杂音·胸骨无压痛;肝大2cm,脾未触及,全身骨、髂及关节无压痛。实验室检查:血红蛋白32g/L,白细胞;2.4×10~9/L,中性1%,淋巴54%,单核2%,浆细胞3%;Pt1.5万,网织红细胞0.1%,脑絮(++),麝絮(+++),GPT76u,(赖氏法);AKP3.5u血清蛋白电泳正常。骨髓象;(三次)增生极度减低,晚粒11%,杆分40%,嗜硷9%,中幼红10%,晚红21%,淋巴6%,浆细胞3%。巨核细胞未找见,骨髓小粒呈空网架。诊断为急性再障给予

Patient, male, 62 years old, hospital ad 2284. Due to diarrhea after taking chloramphenicol 6 days, nose, gingival bleeding more than ten days, on April 8, 1980 admitted. Physical examination: T38.5 ℃, P110 times. Severe anemia appearance: the size of the neck lymph nodes like soybeans; see a few bleeding points in the abdomen. Heart to the left to expand the apical area can be heard Grade Ⅲ systolic hair blowing murmur sternal no tenderness; liver 2cm, spleen not touched, the whole body bone, iliac and joint no tenderness. Laboratory tests: hemoglobin 32g / L, white blood cells; 2.4 × 10 ~ 9 / L, 1% neutral, lymph 54%, mononuclear 2%, plasma cells 3%; Pt15000, reticulocytes 0.1%, brain Xu (++), musk floss (+++), GPT76u, (Lai’s method); AKP3.5u serum protein electrophoresis normal. Bone marrow; (three) extremely reduced hyperplasia, 11% late, pole 40%, alkalophilic 9%, 10% of red, red late 21%, lymphatic 6%, plasma cells 3%. Megakaryocytes not seen, bone marrow particles were empty grid. Diagnosed as acute aplastic anemia