血栓性血小板减少性紫癜误诊1例

Misdiagnosis of thrombotic thrombocytopenic purpura:a case report

患者，女，19岁，因“发热、腹泻3d，伴牙龈出血、右肩右髋部出血点1d”，至我院急诊就诊。患者入院前3d无明显诱因出现腹泻、呕吐、高热、腹痛，腹泻初为水样便，量多，后逐渐为黑色便，发热体温最高达40℃。在家自服去痛片、阿莫西林、安乃近等药。入院前1d出现牙龈出血，伴右肩、右髋部出血点。来诊时急查化验示血常规：

Summary A 19-year-old female had fever with diarrhea for three days. Her gum and skin bleed for one day. Laboratory results revealed; anemia, thrombocytopenia, elevated serum creatinine. Initially, she was misdiagnosed as idiopathic thrombocytopenic purpura （ITP）. Although she was diagnosed as thrombotic thrombocytopenic pur- pura （TTP）at last,hut still died.