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患儿,男,3岁,体重12kg。因发热,脓血便在外院服痢特灵0.1g,每日3次。次日面色突然苍白,尿呈酱油色,又服痢特灵0.1g,2次,症状加重,急症入院。查体:T37.1℃,BP13/8kPa。精神差,颜面、眼结合膜、口唇苍白。心率124次/min;肝肋下1.5cm,剑突下2.5cm,触痛;脾在肋缘下触及。实验室检查:Hb 55g/L,RBC1.86×10～(12)/L,WBC11.5x 10～9/L,BPC136×10～9/L,Ret 0.12。涂片示红细胞呈多形性,大小不等,可见有核红细胞。尿蛋白(±),尿潜血(-),尿胆原(+),尿胆红质(-)。肝功能正常。直接Coombs试验(-)。红细胞脆性试验正常。骨髓象示红系增生活跃,尤以中,晚幼红细
Children, male, 3 years old, weighing 12kg. Because of fever, pus and blood in the hospital out of furazolidone 0.1g, 3 times a day. Suddenly pale on the next day, urine was soy sauce, and furazolidone 0.1g, 2 times, the symptoms worse, emergency admission. Physical examination: T37.1 ℃, BP13 / 8kPa. Poor spirit, face, eyes combined with membrane, lips pale. Heart rate 124 beats / min; hepatic ribs 1.5cm, xiphoid 2.5cm, tenderness; spleen touch under the costal margin. Laboratory tests: Hb 55g / L, RBC1.86 × 10-12 / L, WBC11.5x10-9 / L, BPC136 × 10-9 / L, Ret 0.12. Smear red blood cells were pleomorphic, ranging in size, visible nucleated red blood cells. Urinary protein (±), urinary occult blood (-), urinary gallbladder (+), urinary bilirubin (-). Liver function is normal. Direct Coombs test (-). Erythrocyte fragility test is normal. Bone marrow shows red hyperplasia active, especially in the late infancy fine