1 case of hemolytic uremic syndrome.docVIP

 PAGE \* MERGEFORMAT 6 1 case of hemolytic uremic syndrome [Keywords:] hemolytic, uremic syndrome A medical record Children, male, 8 years 2 months, due to bleeding skin, pale yellow, edema associated with hematuria 6 days hospitalized. 6 days before admission, children with skin scattered bleeding points in the tip size, with double eyelid edema, urine dark brown, urine output less. doctor at the local hospital is unknown, to penicillin 400 million u / d anti-infection and symptomatic treatment. children with edema gradually weight, urine output gradually less, 1 day before admission, renal dysfunction occurred. 3 days before the disease in children had fever, cough, local hospital anti-infection treatment to be improved. Over the past history and family history: no history of trauma and eating beans history. Past the body and health, no family genetic history. Admission examination: T 36.8 ℃, P 100 times / min, R 24 times / min, blood pressure 140/90 mm Hg, the spirit of poor response is still good. Systemic bleeding and petechiae scattered, yellowish discoloration of skin. Double eyelid, facial edema , scleral jaundice, pale conjunctiva and lips. pharyngeal congestion, not tonsil. lungs coarse breath sounds, heart sounds strong, law Qi, heart rate 100 times / min, the apex grade Ⅱ ~ Ⅲ smell and hair samples systolic murmur. soft abdomen, liver and ribs 4 cm, the quality, the edges sharp, no tenderness and percussion pain, spleen no time, ascites negative; the positive region of both kidneys percussion pain, lower extremity edema non-concave, pale nail bed ; neurological examination was normal. Laboratory tests: blood: hemoglobin 38 g / L, WBC 11.2 × 109 / L, neutrophils 0.65, lymphocytes 0.35, platelets 50 × 109 / L, reticulocytes 12.5%, seen in peripheral blood smears broken red blood cells, no red ball. blood biochemistry: potassium 4.6 mmol / L, sodium 127 mmol / L, chloride 84 mmol / L, calcium 1.7 mmol / L, phosphorus 2.9 mmol / L, the