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坏死增生性淋巴结病以淋巴结肿大,发热、白细胞减少为特征,既往报道预后均佳,笔者近遇一例,初治效佳,复治无效死亡. 女患,15岁,全身淋巴结肿痛、高热、乏力20天入院。T39℃,P120次/分,B P14.6/8kPa,发育营养正常,全身浅淋巴结肿大3×2×2 cm~3,质中,无粘连,有压痛,肝脾可触及,RBC 2.19×10~(12)/L,Hb76g/L,Ret 0.063,WBC2.9×109/L,N0.7,L0.26,M0.03,Pt40×109/L,HBsAg(+),反应性骨髓象。血电解质、肝肾功能、抗“O”、血沉、类风湿因子、免疫球蛋白、血、骨髓、大便培养均阴性。胸片示双肺门淋巴结肿大。住院中曾出现全身麻疹样斑丘疹,经抗痨抗感染治疗无效,取颈及左腋淋巴结活检报告为坏死增生性淋巴结炎.服强的松45mg/d即日热退,续治1
Necrosis of the lymphadenopathy is characterized by lymphadenopathy, fever, leukopenia, the prognosis is good, the author has been close to one case, the initial treatment effect is good, retreatment ineffective death. Female, 15 years old, systemic lymphadenectomy, fever , Fatigue 20 days admission. T39 ℃, P120 beats / min, B P14.6 / 8kPa, the development of normal nutrition, systemic superficial lymph nodes 3 × 2 × 2 cm ~ 3, quality, no adhesions, tenderness, liver and spleen can reach, RBC 2.19 × 10 ~ (12) / L, Hb76g / L, Ret 0.063, WBC 2.9 × 109 / L, N0.7, L0.26, M0.03, Pt40 × 109 / L, HBsAg . Blood electrolytes, liver and kidney function, anti “O”, ESR, rheumatoid factor, immunoglobulin, blood, bone marrow, stool culture were negative. Chest radiograph showed double hilar lymph nodes. Had hospitalized measles-like maculopapular rash, the treatment of anti-tuberculosis infection is invalid, take the neck and left axillary lymph node biopsy reported as necrotizing lymphadenitis. Prednisone 45mg / d immediate retreat, continued treatment 1