临床讨论王秀英医师:本例特点为:1.学龄儿童,发病缓慢。2.巨大肝脾,后期伴有发热。3.血象显示贫血不著,血小板及白血球均减少。4.骨髓增生活跃,无异常细胞发现。在小儿肝脾大常见的疾病有: 1.感染性疾病:(一)急性感染:据病史不考虑。(二)慢性感染:(1)脾结核:有结核接触史、消瘦、咳嗽、肝脾肿大,脾功能亢进可继发血小板减少,有出血倾向等,符合结核病变过程。但患儿为间断发热 Clinical discussion Dr. Wang Xiuying: The characteristics of this case are: 1. School-aged children, the incidence is slow. 2. huge liver and spleen, accompanied by late fever. 3 blood shows anemia, platelets and white blood cells are reduced. 4. Myeloid hyperplasia, no abnormal cells found. In children with common diseases of liver and spleen are: 1. Infectious diseases: (A) acute infection: According to the history did not consider. (B) chronic infection: (1) splenic tuberculosis: a contact history of tuberculosis, weight loss, cough, hepatosplenomegaly, hypersplenism secondary to thrombocytopenia, bleeding tendency, consistent with tuberculosis process. However, children with intermittent fever