#16
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Õëàìèäèÿ ïíåâìîíèå ìîæåò áûòü âèíîâàòà? Åñëè íåò ïðèçíàêîâ ïíåâìîíèè...íî àíòèòåëà è ì è g ïîâûøåíû â 2-3 ðàçà.
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#17
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Âðàêè ýòî è ãèïåðäèàãíîñòèêà - öåæ íå ñâîè äåòè, ìîæíî îïóõîëåâûé ä-ç âêàòèòü è ïîòîì õèìèþ, è ïîñëå 99.9% èçëå÷åíèå, ëó÷øå ñòîÿòü çà âûñîêèå ïîêàçàòåëè, ÷åì "ñèäåòü" çà íèçêèå, ïî ìîèì ãðóáûì ïîäñ÷åòàì äåòÿì â ÐÔ â 5-10 ðàç ñòàâÿò ýòîò äèàãíîç, ÷åì ãäå-ëèáî åùå â ìèðå, çåìëÿ ïðîêëÿòàÿ èëè øîñü íå òî â "äàòñêîì êîðîëåâñòâå"? Ïîëàãàþ, ÷òî è áèîïñèÿ ë/ó Âàøåìó ðåáåíêó çàêîí÷èòñÿ òîé æå ïå÷àëüþ
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#18
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åùå îäíà îòå÷åñòâ. ôèøêà - âàëèòü âñå íà õëàìèäèþ, õîðîøî ÷òî íå íà ãîíîðåþ èëè ñèôèëèñ - èñêëþ÷àòü ó ðåáåíêà íóæíî ñëåäóþùåå èç ñïèñêà, ãäå áîëåå 2 ñëó÷àåâ:
CMV:3, EBV:7, Influenza A:5, Influenza B:9, HSV:5, HHV6:3, PARVO B19:5,
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#19
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Åâv ìû èñêëþ÷èëè âðîäå. Àíàëèç ñ õðîíè÷åñêîé ëàòåíòíîé èíôåêöèåé.
Öèòîìåãàëîâèðóñ - îòðèöàòåëüíî. Èíôëþåíñà- åù¸ íå ñåçîí. Âèðóñ ïðîñòîãî ãåðïåñà 1… 2 îòðèöàòåëüíî. Îñòà¸òñÿ ãåðïåñ 6 òèïà è ïàðâîâèðóñ. |
#20
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È ÷òî òî ÿ èñïóãàëàñü ýòîé ãèïåðäèàãíîñòèêè. À åñëè âäðóã è åù¸ äâà ìîðôîëîãà ïåðåñìîòðÿò, òî äîñòàòî÷íî óáåäèòåëüíî èëè åù¸ ìîæåò Ïýò ÊÒ ïîìîãàåò ïîäòâåðäèòü äèàãíîç?
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#21
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Òåîðåòè÷åñêè Ïýò ÊÒ ìîæíî èñïîëüçîâàòü äëÿ äèô äèàãíîçà âîñïàëèòåëüíûõ è ïîðàæåííûõ ëèìôîìîé ë/ó?
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#22
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âîò ÷òî ïèøóò: ÊÒ è ÏÅÒ îäíîâðåìåííî ïîìîãàþò îòëè÷èòü îäíó ëèìôîìó îò äðóãîé
A combination CT scan and PET scan may be used to diagnose lymphoma and help differentiate between Hodgkin and non-Hodgkin lymphoma. íåõîäæêèíñêàÿ ëèìôîìà - êàçóèñòèêà ó äåòåé, õîäæêèíñêàÿ ÷àùå, íî ïîñëå 15 ëåò-âîçðàñòà
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
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#23
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åùå - íàèáîëåå ÷àñòîé ïðè÷èíîé øåéíîé ëèìôàäåíîïàòèåé ó äåòåé ÿâëÿåòñÿ ÝÁ - íå çíàþ, ÷òî òàì "Åâv ìû èñêëþ÷èëè âðîäå. Àíàëèç ñ õðîíè÷åñêîé ëàòåíòíîé èíôåêöèåé." íî îòâåò ïîõîæå âèäåí íåâîîðóæåííûì âçãëÿäîì - îáðàòèòåñü ê ñïåöàì è ïîëó÷èòå âòîðîå ìíåíèå:
Epstein-Barr virus was the most prevalent cause of cervical lymphadenopathy (8.86%; 95% CI = 7.81-9.96)
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#24
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Ñåãîäíÿ ñäåëàëè ÊÒ. Íå ïîëó÷èëîñü ñ êîíòðàñòîì, âûÿâèëè óâåëè÷åíèå Ëó øåè ãëóáîêèå äî 16 ìì, íàäêëþ÷è÷íûé è ïîâåðõíîñòíûå íå îïèñûâàþò, ïîäìûøå÷íûå ñëåâà êîíãëîìåðàò äî 34 ìì, îêðóæ¸ííûé ìíîæåñòâåííûìè óâåëè÷åííûìè Ëó è êîíãëîìåðàòàìè, ñïðàâà â âåðõóøêå î÷àã 4 ìì âåðîÿòíî Ëó, óïëîòíåíèå ìåæäîëåâîé ïëåâðû s3…6. Êàðòèíà ëèìôîïðîëèôåðàòèâíîãî ïðîöåññà, áîëüøå âûðàæåííîãî â ïîäìûøå÷íîé îáëàñòè.
 áðþøíîé ïîëîñòè êîëè÷åñòâåííàÿ ëèìôàäåíîïàòèÿ ìåçêíòåðèàëüíîé îáëàñòè áåç óâåëè÷åíèÿ ðàçìåðîâ ëèìôîóçëîâ. Ãåïàòîìåãàëèÿ 180-158 ìì. Ñïëåíîìåãàëèÿ. |
#25
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Èíôåêöèîíèñòà ïîïðîøó ïðèãëàñèòü. Íî õðîíè÷åñêèé åâv âðîäå êàê ó âñåõ. Íàì íóæíà àêòèâàöèÿ, à åå íåò.
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#26
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Åùå îòêóäà ðàñòóò íîãè ó äåòñêèõ ëèìôîì â ÐÔ, êîãäà íåò ñïåöèàëüíûõ çíàíèé è ôåíîòèïèðîâàíèÿ:
The earliest manifestation of acute infectious mononucleosis may be a prominent monocytoid B-cell proliferation, along with reactive follicular hyperplasia. However, soon after, there is an immunoblastic proliferation, which may be quite striking. These cells typically have prominent nucleoli and abundant cytoplasm. They have a high mitotic rate and may form sheets, may be found in sinuses, and may be multinucleated, mimicking either non-Hodgkin lymphoma or Hodgkin lymphoma. The differential diagnosis includes both non-Hodgkin lymphoma and Hodgkin lymphoma. Misdiagnosis of acute infectious mononucleosis as Hodgkin or non-Hodgkin lymphoma is a common error in lymph-node pathology. Simply stated, one should not diagnose a diffuse large cell lymphoma in either the tonsil or cervical lymph nodes in a child or adolescent without first considering and ruling out a possible diagnosis of acute infectious mononucleosis!
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#27
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ß áû òîæå ïîïðîñèë èíôåêöèîíèñòà, åñëè áû îíè áûëè íà ôîðóìå, Âàì ïðèäåòñÿ èõ ñàìèõ èñêàòü â ðåàëèè è ïîëó÷àòü âòîðîå ìíåíèå îôô-ëàéí
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#28
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Primary (new or recent) infection
People are considered to have a primary EBV infection if they have anti-VCA IgM but do not have antibody to EBNA. Other results that strongly suggest a primary infection are a high or rising level of anti-VCA IgG and no antibody to EBNA after at least four weeks of illness. Resolution of the illness may occur before the diagnostic antibody levels appear. In rare cases, people with active EBV infections may not have detectable EBV-specific antibodies. Viral capsid antigen (VCA) Anti-VCA IgM appears early in EBV infection and usually disappears within four to six weeks. Anti-VCA IgG appears in the acute phase of EBV infection, peaks at two to four weeks after onset, declines slightly then persists for the rest of a person’s life. Early antigen (EA) Anti-EA IgG appears in the acute phase of illness and generally falls to undetectable levels after three to six months. In many people, detection of antibody to EA is a sign of active infection. However, 20% of healthy people may have antibodies against EA for years. EBV nuclear antigen (EBNA) Antibody to EBNA, determined by the standard immunofluorescent test, is not seen in the acute phase of EBV infection but slowly appears two to four months after onset of symptoms and persists for the rest of a person’s life. Other EBNA enzyme immunoassays may report false positive results.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#29
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Ea igG - 2.6 îòð íîðìà 0-15
Vca IgG 97.4 ïîëîæ 0-15 Vca IgM 4.0 îòð 0-13 Ebna IgG 16.4 ïîëîæ. 0-3 |
#30
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Ó íàñ ñåãîäíÿ ðàäîñòü: àíàëèç êðîâè çíà÷èòåëüíî óëó÷øèëñÿ, ëåéêîöèòû 3.18… òðîìáîöèòû 342! Íåéòðîôèëû 0.96 10*9/ë. Ñîý 4 ìì/ ÷. Áèîïñèþ ëèìôîóçëîâ ïîêà ðåøèëè îòëîæèòü è ïîíàáëþäàòü.
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