一例全身型幼年特发性关节炎并发巨噬细胞活化综合征的主要诊断及编码探讨

Discussion of the Main Diagnosis and Encoding of a Case of Systemic Juvenile Idiopathic Arthritis Complicated with Macrophage Activation Syndrome

全身型幼年特发性关节炎的部分患儿在病程中可并发巨噬细胞活化综合征,而巨噬细胞活化综合征会造成全身多器官损伤。通过阐述一例全身型幼年特发性关节炎并发巨噬细胞活化综合征病例的主要诊断选择及编码查找的过程,进而探讨疑难病例主要诊断的正确选择及编码的查找。本病例虽然巨噬细胞活化综合征只是全身型幼年特发性关节炎的一个并发症,但是全身型幼年特发性关节炎并不致死,而患儿发生巨噬细胞活化综合征的病情却十分危重,所以应选择巨噬细胞活化综合征为主要诊断,ICD-10编码D76.1,全身型幼年特发性关节炎为其他诊断,ICD-10编码M08.2。

Macrophage activation syndrome may occur in the course of the disease in some children with systemic juvenile idiopathic arthritis, macrophage activation syndrome can cause multiple organ damage in the whole body. The author expounds on a case of systemic juvenile idiopathic arthritis concurrent macrophage activation comprehensive syndrome were mainly diagnosed and code searching process, and then discuss the correct choice of the main diagnosis of difficult cases and encoding search. In this case, although the macrophage activation syndrome is systemic juvenile idiopathic arthritis a complication, but systemic juvenile idiopathic arthritis is not lethal, while the children of macrophages activation syndrome, the condition is very critical, so this case should select the ＂macrophage activation syndrome＂ as the main diagnosis and ICD-10 coding D76.1.＂systemic juvenile idiopathic arthritis＂for other diagnostic and ICD-10 coding M08.2.