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女患,58岁,于两月前无明显诱因出现头面及预侧部皮肤搔痒,呈紫红色皮疹,续而向胸部双上肢蔓延,四肢肌肉酸痛,活动受限。面部及双下肢明显浮肿,尿少、胸闷、气急、吞咽困难、不能翻身及抬头,急诊入院。既往无“肾炎”及“结缔组织性疾病”史。体检:T37℃,P90次/分,R21次/分,Bp17/12kPa慢性面容,面部及双眼睑浮肿,头、面及前胸部、双上肢皮肤均见斑片状紫红色皮疹,四肢肌肉肿胀,触压痛明显、心肺、肝脾正常、双肾区有叩痛,双下肢凹陷性水肿。实验室检查:Hb8.0g/L RBC2.7×10~(12)/L WBC
Female, 58 years old, no obvious incentive to appear two months ago, the head and the pre-side skin itching, a purple rash, continued to spread to the upper extremity of the chest, limbs, muscle soreness, limited mobility. Obvious swelling of the face and lower extremities, oliguria, chest tightness, shortness of breath, difficulty swallowing, can not stand up and rise, emergency admission. No previous “nephritis” and “connective tissue disease” history. Physical examination: T37 ℃, P90 beats / min, R21 beats / min, Bp17 / 12kPa chronic face, facial and double eyelid edema, head and face and front chest, both upper extremity skin patchy purple skin rash, limb muscle swelling, Touching tenderness obviously, heart and lung, liver and spleen normal, there are percussion pain in the area of both kidneys, both lower limb pitting edema. Laboratory tests: Hb8.0g / L RBC2.7 × 10 ~ (12) / L WBC