Chapter 367 Final diagnosis! Incurable disease!
"oh."
Xu Qiu marked several inappropriate places on a medical record, signed it, and raised his head.
Joseph and Director Shen looked at each other, their confusion getting deeper and deeper.
There is no measles virus!
This means that all the speculations at the impromptu meeting were wrong!
It’s not measles that replicates for a long time and triggers a violent immune system reaction!
Why is Xu Qiu so calm?
"It's just negative." Xu Qiu added before the two of them could react.
"???"
At this moment, Joseph was completely confused.
What the hell?
Didn't you say that the cause is the measles virus?
Now that the measles antibody is positive, you turn around and say it's normal. What the hell!
Xu Qiu calmly pulled out Fan Fuguo's medical records and turned to the pages where Linhai International Friendship Hospital diagnosed multiple sclerosis.
Joseph didn't know why: "What's the problem? Multiple sclerosis is indeed treated with corticosteroids."
Director Shen also scratched his head: "Yes, later it was suspected that it was severe multiple sclerosis, so immunoglobulin, plasma exchange and other measures were added. However, they had no effect, so they were ruled out."
Although this period is considered a misdiagnosis, it is a necessary diagnosis and treatment process for rare diseases and difficult and complicated diseases.
Reasonable speculation and experimental administration are also important means of clinical diagnosis.
Xu Qiu pointed at "corticosteroids" and said, "That's the problem."
"What's the meaning?"
Joseph looked confused, and was about to continue asking, but suddenly thought of something, and his expression changed: "High-dose and long-term corticosteroid treatment can inhibit the production of IgG antibodies to a certain extent...
But that’s not right. If the measles virus replicates for a long time, how can it be suppressed so easily? "
As he spoke, Joseph's voice became smaller and smaller.
The next moment he picked up Fan Fuguo's medical record and considered it carefully.
"Yes, there are immunoglobulins and plasma exchange...
Immune globulin can neutralize the measles virus in the body!
Plasma exchange can replace all anti-measles virus IgG antibodies in the body! "
Joseph suddenly raised his head, his face full of surprise.
There was indeed measles virus in the patient's body, but because Linhai International Friendship Hospital determined the diagnosis to be multiple sclerosis, and the subsequent treatment measures happened to cover up the evidence, no trace of infection could be found!
Corticosteroids inhibit antibody production.
Immunoglobulins neutralize the measles virus itself.
Plasma exchange replaces all previously produced antibodies.
Due to many coincidences, there was no trace of measles virus infection in Fan Fuguo's body, and everything seemed normal.
However,
The three treatment options for multiple sclerosis can only mask the presence of the measles virus, but they cannot cure it.
Therefore, while he was negative for measles, his condition continued to worsen.
"It's confirmed, it's subacute sclerosing panencephalitis!" Joseph was shocked, and he still found it unbelievable.
From the time Fan Fuguo was admitted to the hospital until now, Xu Qiu has been crushing him in every aspect.
To understand Creutzfeldt-Jakob disease, Xu Qiu proposed the relationship between the strength and weakness of the lace sign, and then mentioned four highly sensitive areas.
However, the three markers that Joseph had previously mastered were worthless in Xu Qiu's eyes.
Facts have proved that the so-called 14-3-3 protein, Tau protein and S-100 protein can indeed only be used negative to rule out Creutzfeldt-Jakob disease, while all positives do not provide much diagnostic evidence for Creutzfeldt-Jakob disease.
In subsequent diagnostic procedures, Xu Qiu surpassed them in all aspects. His meticulous logic, rich knowledge, and clinical judgment when he was desperate were also unmatched.
Although Creutzfeldt-Jakob disease is a neurological disease, Joseph and other famous foreign doctors have inherent weaknesses.
However, this alone is enough to show that Xu Qiu is indeed talented and knowledgeable.
"That's not good..." Director Shen sighed.
The good news is that Xu Qiu's analysis has confirmed the diagnosis of subacute sclerosing panencephalitis.
However……
Subacute sclerosing panencephalitis is also an incurable disease.
It is caused by persistent and chronic infection with mutated measles virus. The onset is extremely insidious. During the incubation and replication period of the measles virus, it does not invade the immune system of the body and does not cause any symptoms.
This balance can be maintained for several years, ten years, or even decades, so long that everyone thinks the virus has been completely eliminated without leaving any sequelae.
Then at a certain moment, the amount of virus finally breaks through the critical point, activating the immune system and causing a scourge of disease.
International consensus divides its onset into four stages.
The first stage is mainly the decline of high-level neurological functions, such as inattention, mental decline and other cognitive function decline, which may also be accompanied by personality changes.
This is somewhat similar to Tao Changhan, who suffers from mutism.
In the second stage, the damage worsens and gradually develops symptoms of myoclonus, epilepsy, extrapyramidal damage, and visual impairment caused by progressive chorioretinitis, lasting three to twelve months.
This is also a symptom that misled Xiao Liu and the deputy director of Guoyou Hospital, mistakenly making them consider multiple sclerosis, Creutzfeldt-Jakob disease and other diseases.
The third stage is also called the opisthotonus and coma stage.
At this time, various symptoms will be further aggravated, with decerebrate and decortical rigidity, and even the body will bend like a bow. In severe cases, it will bend to a degree that normal humans cannot do, but only myoclonus will gradually decrease.
This stage lasts for one to four months. When it progresses to the third stage, myoclonus will gradually decrease at first, and other symptoms have not yet appeared. Inexperienced doctors will mistakenly think that the condition has improved...
But in fact, this is a more cruel disease progression.
The last stage is the stage where all cortical functions are lost and subcortical functions are partially retained. Eventually, death will occur due to circulatory failure or secondary infection.
That is, vegetative state!
The vegetative stage can also last for several years.
Although it is not like Creutzfeldt-Jakob disease, the medical community basically knows nothing about it.
At least, subacute sclerosing panencephalitis is a disease that has been studied more thoroughly.
However...
Like CJD, there is no treatment for subacute sclerosing panencephalitis. The only way is to give some anti-epileptic drugs, antiviral drugs, interferon and transfer factor and other symptomatic treatments to relieve the patient's symptoms, improve immunity as much as possible, and improve the patient's quality of life.
Now Fan Fuguo should be in the second stage, and conservatively estimated that he still has six months to two years to live.
There have been cases of survival of more than ten years in the world, but they are rare.
It is not a problem to say that subacute sclerosing panencephalitis is 100% fatality rate like CJD.
This news is extremely cruel to the family members, at least to Fan Fuguo's grandchildren and wife.
"Next, there is only one last question."
Xu Qiu's attention was all on the patient, and he put the pen back into the pen holder.
The pen holder in the office was already full.
Joseph's pupils were shocked.
No wonder you can't find the red pen all day, you play with the red pen collection in the office? ? ?
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