摘要
目的郎格罕细胞组织细胞增生症(Langerhans cell histiocytosis,下称LCH)较少见,为减少误诊病例的发生,将8例LCH病例的误诊原因进行分析。方法用回顾性分析法对8例LCH病例的误诊原因进行分析。结果8例IJCH病儿中,男6例、女2例;年龄10个月-8岁;主要症状分别为发热7例、咳嗽5例,骨痛、多饮多尿各2例;鼻衄、黄疸、腹泻各1例;病程1个月-半年;主要体征分别为头部肿物、皮疹各5例;淋巴结肿大,肺部湿罗音各4例,肝脾肿大3例;主要实验室检查6例病理片找到大量LC及X线、CT示颅骨缺损;贫血3例,找到大量嗜酸细胞及异型巨细胞1例;误诊的疾病分别为尿崩症、肺炎各2例,支气管炎、头皮疖肿、关节炎、菌痢各1例,诊断不明1例;最后确诊勒雪综合征(LSD)、韩薛柯氏病(HSCD)各3例,骨嗜酸性肉牙肿(EG)、2例,除2例失访、1例仍在随访外,其余5例均在2个月内死亡。本病的常见误诊原因有:1.对本病的特殊表现认识不足且询问病史与检查马虎,失去重要线索;2.合并感染,掩盖了原发病;3.未能结合临床正确分析辅助检查。结论要重视LCH的症状、体征和实验室检查,综合分析从而得出正确的诊断,以免误诊。
Objective : We have seen LCH very little, in order to reduce missed cases take place, we analysis reason of misdiagnosis in 8 cases. Methods- We used look back analysis method proceed reason of misdiagnosis. Results: Misdiagnosis asdiabetes insipidus were 2 cases , pneumonia were 2 cases , bronchitis , skin boil , arthritis , dysentery & unknown cause of diagnosis was 1 case every . Diagnosis LSD & HSCD were 3 cases every , EG were 2 cases . Common cause of misdiagnosis as follows : 1. As for special manifest of LCH understand insufficient. 2. Be complicated by infection cover up the LCH. 3. Without correct analysis result of sup- plementary check. Conclusion: Must pay attention to symptom , sign & result of supplementary check , comprehensive analysis various circumstance , obtain thus we can right diagnosis , in order to avoid misdiagnosis.
出处
《中国优生与遗传杂志》
2008年第11期116-118,共3页
Chinese Journal of Birth Health & Heredity