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这只手的手指缺血坏死?

2016-11-18 佚名 医学信使微信号（med2doc）

性巨球蛋白血症手指
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根据这张图片，您认为最可能的诊断是什么？（单选）钙化防御凝血因子V莱顿突变蛋白质C缺乏硬皮病原发性巨球蛋白血症公布答案：原发性巨球蛋白血症。这例71岁男性老人诊断为原发性巨球蛋白血症，因血液高黏状态、紫癜和冷球蛋白血症性血管炎，发生进行性手指和脚趾缺血性损害。病人需要做截肢。原发性巨球蛋白血症，主要临床表现为巨球蛋白所致的高黏滞血症。本病病因不明,多发于50岁以上男性。


根据这张图片，您认为最可能的诊断是什么？（单选）


钙化防御


凝血因子V莱顿突变


蛋白质C缺乏


硬皮病


原发性巨球蛋白血症






公布答案：原发性巨球蛋白血症。这例71岁男性老人诊断为原发性巨球蛋白血症，因血液高黏状态、紫癜和冷球蛋白血症性血管炎，发生进行性手指和脚趾缺血性损害。病人需要做截肢。原发性巨球蛋白血症，主要临床表现为巨球蛋白所致的高黏滞血症。本病病因不明,多发于50岁以上男性。

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  1. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Mon Nov 21 07:04:22 CST 2016, time=2016-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156968, encodeId=6e5c15696810, content=原发性巨球蛋白血症少见, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Sun Nov 20 01:05:54 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362816, encodeId=292e1362816a5, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, 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encodeId=6c03156539ed, content=仅仅只有手指表现么, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5rqTiaMSVSkFAupcTECOTdcVRmJQXbibJoicv5ibhcpa0vj5MGmac8wlPjuGnJISZGtOnC7rW0gbLuSE7iaEvAn0CC52ZhnRLdxtlQ/0, createdBy=1e291737907, createdName=1df01bccm39(暂无匿称), createdTime=Fri Nov 18 08:05:09 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156536, encodeId=df07156536b6, content=可怕的病, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b2c1297487, createdName=ghy_happy, createdTime=Fri Nov 18 07:58:57 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156529, encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2017-10-06 智智灵药

    #缺血坏死#

    0

  2. 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encodeId=6c03156539ed, content=仅仅只有手指表现么, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5rqTiaMSVSkFAupcTECOTdcVRmJQXbibJoicv5ibhcpa0vj5MGmac8wlPjuGnJISZGtOnC7rW0gbLuSE7iaEvAn0CC52ZhnRLdxtlQ/0, createdBy=1e291737907, createdName=1df01bccm39(暂无匿称), createdTime=Fri Nov 18 08:05:09 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156536, encodeId=df07156536b6, content=可怕的病, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b2c1297487, createdName=ghy_happy, createdTime=Fri Nov 18 07:58:57 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156529, encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-23 飘飘爱

    很独特

    0

  3. 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encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-22 邓启付

    原发性巨球蛋白血症引起末端缺血坏死

    0

  4. 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createdTime=Wed Nov 23 08:50:02 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157364, encodeId=278e15e36401, content=原发性巨球蛋白血症引起末端缺血坏死, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Tue Nov 22 01:14:46 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157175, encodeId=d85415e175ac, content=以前不了解这种病，还以为是糖尿病引起的, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Mon Nov 21 07:04:22 CST 2016, time=2016-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156968, encodeId=6e5c15696810, content=原发性巨球蛋白血症少见, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Sun Nov 20 01:05:54 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362816, encodeId=292e1362816a5, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, 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encodeId=6c03156539ed, content=仅仅只有手指表现么, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5rqTiaMSVSkFAupcTECOTdcVRmJQXbibJoicv5ibhcpa0vj5MGmac8wlPjuGnJISZGtOnC7rW0gbLuSE7iaEvAn0CC52ZhnRLdxtlQ/0, createdBy=1e291737907, createdName=1df01bccm39(暂无匿称), createdTime=Fri Nov 18 08:05:09 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156536, encodeId=df07156536b6, content=可怕的病, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b2c1297487, createdName=ghy_happy, createdTime=Fri Nov 18 07:58:57 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156529, encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-21 邓启付

    以前不了解这种病，还以为是糖尿病引起的

    0

  5. 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encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-20 邓启付

    原发性巨球蛋白血症少见

    0

  6. 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encodeId=6c03156539ed, content=仅仅只有手指表现么, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5rqTiaMSVSkFAupcTECOTdcVRmJQXbibJoicv5ibhcpa0vj5MGmac8wlPjuGnJISZGtOnC7rW0gbLuSE7iaEvAn0CC52ZhnRLdxtlQ/0, createdBy=1e291737907, createdName=1df01bccm39(暂无匿称), createdTime=Fri Nov 18 08:05:09 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156536, encodeId=df07156536b6, content=可怕的病, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b2c1297487, createdName=ghy_happy, createdTime=Fri Nov 18 07:58:57 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156529, encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-19 millore

    #坏死#

    0

  7. 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encodeId=6c03156539ed, content=仅仅只有手指表现么, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5rqTiaMSVSkFAupcTECOTdcVRmJQXbibJoicv5ibhcpa0vj5MGmac8wlPjuGnJISZGtOnC7rW0gbLuSE7iaEvAn0CC52ZhnRLdxtlQ/0, createdBy=1e291737907, createdName=1df01bccm39(暂无匿称), createdTime=Fri Nov 18 08:05:09 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156536, encodeId=df07156536b6, content=可怕的病, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b2c1297487, createdName=ghy_happy, createdTime=Fri Nov 18 07:58:57 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156529, encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-19 邓启付

    这个缺血坏死太恐怖了，没见过这么严重的坏死。

    0

  8. 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encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-18 1df01bccm39(暂无匿称)

    仅仅只有手指表现么

    0

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encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-18 ghy_happy

    可怕的病

    0

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encodeId=6c03156539ed, content=仅仅只有手指表现么, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5rqTiaMSVSkFAupcTECOTdcVRmJQXbibJoicv5ibhcpa0vj5MGmac8wlPjuGnJISZGtOnC7rW0gbLuSE7iaEvAn0CC52ZhnRLdxtlQ/0, createdBy=1e291737907, createdName=1df01bccm39(暂无匿称), createdTime=Fri Nov 18 08:05:09 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156536, encodeId=df07156536b6, content=可怕的病, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b2c1297487, createdName=ghy_happy, createdTime=Fri Nov 18 07:58:57 CST 2016, time=2016-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=156529, encodeId=d1d315652958, content=初次见，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xwU6047w4GQZHmaJMe3cGxCqPS0x43a9R04dN3HrAn5diaR2N4pEwoibqiaiaA3m6ia3g3XbZXadIomlRa5WAvjSUHb/0, createdBy=93aa1715091, createdName=为啥子, createdTime=Fri Nov 18 07:17:25 CST 2016, time=2016-11-18, status=1, ipAttribution=)]
    2016-11-18 为啥子

    初次见，学习了

    0

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