发热、意识障碍-蛋白尿-贫血-抗磷脂抗体阳性  

Fever with disturbance of consciousness-proteinuria-anemia-positive anticardiolipin antibody

作　　者：郑金相 王立 陈洋[2] 王曦[3] 韩菲[4] 周宝桐[5] 陈苗[6] 林路[7] 秦绪珍[8] 师杰[9] 蒋颖 郑文洁 曾小峰 张奉春 Zheng Jinxiang;Wang Li;Chen Yang;Wang Xi;Han Fei;Zhou Baotong;Chen Miao;Lin Lu;Qin Xuzhen;Shi Jie;Jiang Ying;Zheng Wenjie;Zeng Xiaofeng;Zhang Fengchun(Department of Rheumatology and Clinical Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Key Laboratory of Rheumatology and Clinical Immunology,Ministry of Education,Beijing 100730,China;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Infectious Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Hematology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Laboratory Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Internal Medicine,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院风湿免疫科教育部重点实验室,100730 [2]中国医学科学院北京协和医学院北京协和医院消化内科,100730 [3]中国医学科学院北京协和医学院北京协和医院内分泌科,100730 [4]中国医学科学院北京协和医学院北京协和医院神经内科,100730 [5]中国医学科学院北京协和医学院北京协和医院感染内科,100730 [6]中国医学科学院北京协和医学院北京协和医院血液内科,100730 [7]中国医学科学院北京协和医学院北京协和医院放射科,100730 [8]中国医学科学院北京协和医学院北京协和医院检验科,100730 [9]中国医学科学院北京协和医学院北京协和医院病理科,100730 [10]北京市大兴区中西医结合医院内科,100076

出　　处：《中华全科医师杂志》2020年第10期962-964,共3页Chinese Journal of General Practitioners

摘　　要：患者女,32岁,因"发热、意识障碍10 d"于2016年10月20日入院。患者10 d前发热,体温最高38.7℃,伴畏寒,后意识模糊、言语不清,曾就诊当地医院,予抗感染及脱水降颅压治疗(具体不详)无好转,遂至北京协和医院急诊。瞳孔大小不等,直接、间接对光反射迟钝,略有颈强直。外周血常规检查示白细胞计数22.51×10^9/L,中性粒细胞占比0.93,血红蛋白42 g/L,平均红细胞体积78.2 fl,血小板752×10^9/L,网织红细胞0.13%。肝肾功能检查示白蛋白23 g/L,肌酐(Cr)224μmol/L,尿素氮14.68 mmol/L,二氧化碳结合率14.3 mmol/L。ESR>140 mm/1 h,超敏C反应蛋白149.7 mg/L。

关 键 词：糖尿病 中枢神经系统疾病 自身免疫疾病 

分 类 号：R593.2[医药卫生—内科学] R696.2[医药卫生—临床医学] R556