Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Am J Hematol. 2013 Aug;88(8):713-6. doi: 10.1002/ajh.23485. Epub 2013 Jul 8.
Patients with an apparent bleeding disorder can usually be diagnosed by a careful history, physical examination, and screening laboratory tests. However, at times the constellation of bleeding signs and symptoms fail to be explained by test results and/or our current understanding of hemostatic mechanisms. One such patient is the subject of the current report. She is a 13-year-old female with a history of striking bleeding manifestations, including spontaneous hemorrhage from her eyes, scalp, hands, and feet. She was evaluated by one of the authors at a teaching hospital in Mumbai, India in March 2009 during the filming of a National Geographic Channel documentary characterizing puzzling medical disorders encountered in India. Given her unusual bleeding manifestations, she received international media attention at the time. National Geographic and a film company in the United Kingdom subsequently expressed interest in highlighting the patient to document her seemingly rare hematologic disorder and contacted the American Society of Hematology to identify an American hematologist to further investigate the case. With consent of the family and collaboration with a hematologist practicing at a teaching hospital in Mumbai, filming commenced during March 2009 in an attempt to capture the patient's diagnosis and the cultural and medical milieu in which the bleeding events occurred.
患有明显出血性疾病的患者通常可以通过仔细的病史、体格检查和筛选实验室检查来诊断。然而，有时出血迹象和症状的组合无法用测试结果和/或我们目前对止血机制的理解来解释。当前报告的主题就是这样一位患者。她是一名 13 岁的女性，有明显的出血表现，包括眼睛、头皮、手和脚自发性出血。她于 2009 年 3 月在印度孟买的一家教学医院由其中一位作者进行评估，当时正在拍摄一部以印度遇到的令人费解的医学疾病为特色的国家地理频道纪录片。鉴于她不寻常的出血表现，她当时受到了国际媒体的关注。国家地理和英国的一家电影公司随后表示有兴趣突出这位患者，以记录她看似罕见的血液疾病，并联系美国血液学会寻找一位美国血液学家来进一步调查该病例。在获得患者家属同意并与在孟买一家教学医院工作的血液学家合作的情况下，拍摄于 2009 年 3 月开始，试图捕捉到患者的诊断以及出血事件发生时的文化和医疗环境。
