This doctor is great

Chapter 238 Lupus Crisis!

this rash,

It immediately caught the attention of Zhang Mei and Zhou Mo.

So many previous examinations have not yet confirmed what the disease is.

And the rash may be able to rule out many options at once.

Teacher Zhang Mei and Zhou Mo quickly came to the patient's bedside.

"You have a rash, right?"

"Yes."

"When did it happen, does it itch?"

"There were two days ago..."

"Let me see."

Teacher Zhang Mei said.

The patient Chen Xiuya looked at Zhou Mo, blushed, and finally nodded.

"Trouble doctor."

The patient's parents next to him glanced at Zhou Mo, but out of trust in the doctor, and because Zhou Mo was pleasing to the eye and not wretched, they hesitated for a while and then stopped talking.

Patient Chen Xiuya lifted up her clothes, revealing the rash on her abdomen.

Zhou Mo looked over.

Zhang Mei looked over.

It was indeed a rash, but I couldn't figure out what it was for a while.

Zhang Mei looked at Zhou Mo: "Did you see anything?"

Zhou Mo shook his head, thinking hard.

Because of the rash, the cause is very complicated, and there may be dozens of rashes in the same manifestation.

Take a look at the condition:
The patient has: hair loss, fever, cough, hemoptysis, joint pain, rash, thrombocytopenia, leukopenia...

If you want monism,

Pneumonia, tuberculosis, leukemia, are impossible.

"What kind of disease is it?"

"Is there one disease that can explain everything?"

suddenly,

A disease appeared in Zhou Mo's mind.

The night before yesterday, after Zhou Mo experienced the "gout patient", he went back and checked a lot of information on gout, rheumatism immunity, etc. on uptodate.

identify each other.

Achieve a lot!

And one of them is sick,

——"systemic lupus erythematosus"!
It is a rheumatic immune disease!
Lupus erythematosus is called lupus because when the disease was first discovered, the rash on the face of the patient was found to be similar to the wound that appeared after being bitten by a wolf, so it was called lupus.

"Rheumatic immune disease": refers to a group of diseases that mainly invade bone joints, muscles, bones and soft tissues around joints, causing pain, swelling and stiffness, and can cause damage to multiple systems throughout the body.Common diseases include rheumatoid arthritis joints, systemic lupus erythematosus, ankylosing spondylitis, and Sjogren's syndrome.

in fact,

At the beginning, when Zhou Mo was considering rheumatology and immunology, he thought about this disease, but at that time, because the patient's symptoms were a high fever of more than 39 degrees.But rheumatic immune diseases are basically low-grade fever.

So, ruled out for now.

But now, there's an extra rash.

The possibility of lupus erythematosus is much higher.

monism,

It just happened to explain all the symptoms of the patient.

Fever: If there is a problem with the immune system, a fever will naturally occur.

Hair loss: This disease will cause changes in the skin and hair follicles, so hair loss is also a high probability!Many "systemic lupus erythematosus" patients have symptoms of hair loss!
Thrombocytopenia, leukopenia: Systemic lupus erythematosus should also cause problems with the immune system.

As for coughing up blood, it is just a complication, a complication of thrombocytopenia.

However, there is a problem:

Systemic lupus erythematosus, a typical rash, is - butterfly erythema.

The patient in front of her, Chen Xiuya, was just an ordinary rash.

"Zhou Mo, are you immune to rheumatism?"

"not yet."

"Hurry up... Also, let the dermatology and rheumatology doctors come over."

"it is good."

……

Waited another 20 minutes,

The patient Chen Xiuya has a set of rheumatism immunity, and the results came out.

Multiple positives! !

Diagnosis: systemic lupus erythematosus!
Zhang Mei, Zhou Mo

"What disease is this?"

"Doctor, is the pressure serious?"

"Is this what caused the hair loss?"

Chen Xiuya was a little surprised!
She has been looking for the cause of her hair loss for a long time, and now she has the answer.

Woman, what about hair loss?
The parents are happy to find the cause, as long as the cause is found, the disease can be cured.

At this time, another patient was brought in.

The patient was a young and beautiful girl who was stabbed twice and had a knife wound on her head. She was hacked on the main road, and the reason was unknown.

Zhang Mei: "Xiao Mo, explain to them, I will deal with the patients."

Zhou Mo: "Leave it to me, don't worry."

Then Zhou Mo began to explain to the three family members: "This disease is like this..."

"This disease is an autoimmune inflammatory connective tissue disease that mostly occurs in young women and involves multiple organs. It will produce a large number of antibodies, attack their own immune system, and then cause damage to various organs and tissues throughout the body."

Patient Chen Xiuya: "..."

parents:"…………"

(Reader: "..." I seem to understand this time.)
Parent: "Is that serious?"

Zhou Mo thought for a while, and paid attention to his wording: "This disease... is more troublesome."

There is basically no cure for this disease.

Very serious illness.

Now, this patient, Chen Xiuya, has low platelets and white blood cells, which shows that her "systemic lupus erythematosus" has progressed to a more serious level.

at this time,

Zhou Mo ordered the nurse to have the doctor from the Department of Rheumatology and Immunology come to collect the patient.

but,

For rheumatism immunity, the doctor hasn't come yet.
The patient has a problem.

While Zhou Mo was still explaining to the patient's family,
Zhou Mo glanced at the ECG monitor suddenly from the corner of his eye.

"!!!!!!"

Blood oxygen saturation!

91%! ! !

Zhou Mo was shocked.

Although this blood oxygen saturation is not dangerous, it reveals something not very good!

The lungs have been maintaining blood oxygen very well!

Why did it suddenly drop?

When did it drop?
Looking at the state of the patient Chen Xiuya, she seemed a little pale and groggy.None of the excitement I had when I learned the cause of my hair loss a few minutes ago.

"It's not good!"

At this moment,
Zhou Mo suddenly saw 91% drop down again, 90% off the track!

Zhou Mo's expression changed!
"Could it be... a lupus crisis?!"

A crisis is a particular stage of illness that precedes it.

Such as pituitary crisis, thyroid crisis, parathyroid crisis, risk of hypercalcemia, hypocalcemia crisis, diabetic crisis, hypokalemia crisis...

a lot of.

It is also very common in clinical practice.

Each one is very dangerous and easily fatal.

lupus crisis,

It can also be called "severe systemic lupus erythematosus".

The death rate is high!
Lupus erythematosus is a disease that produces a large number of antibodies that attack its own immune system and cause damage to various organs and tissues throughout the body.

At present, the hematopoietic system and limb joints have been damaged.

Next, it will damage other organs, causing other organs and tissue failure damage, or has already caused failure...

Zhou Mo hurriedly called Teacher Zhang Mei.

But after calling for a long time, I couldn't get through.

At this time, Zhou Mo was in a hurry.

Quickly ordered the nurse: "Go to Teacher Zhang Mei... Then, call the ICU!"

At this time, it is safest for the patient to be sent to the ICU to hang himself.

In fact, it is difficult to deal with this disease in the emergency department.

"Also, call the rheumatology and immunology department, why haven't they come yet?"

Zhou Mo's tone was a little anxious.

.

(End of this chapter)