Ghafouri Rouzbeh R, Araj-Khodaei Mostafa, Targhi Somaiyeh T, Varshochi Mojtaba, Parsian Zahra, Yarani Reza, Golzari Samad E J
Emergency Medicine Research Team, Tabriz University of Medical Science, Tabriz, Iran.
Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran.
Int J Prev Med. 2019 Jan 15;10:6. doi: 10.4103/ijpvm.IJPVM_216_17. eCollection 2019.
Abu Bakr Mohammad Ibn Zakariya Al-Razi (865-925 CE), who was known as "Rhazes" in the west, was a famous scientist of medieval ages. He has more than 200 books and treatises. His masterpiece on medicine "" contains around 900 case reports. Some of the diseases which seem to be recently reported have been stated previously, but not well described. Considering symptoms of the patient described at that time, differential diagnosis will be discussed.
Rhazes described a patient with bilious fever. He had developed bloody urine and stool on the fourth day and fatigue. Subsequently, the patient's urine and stool color turned into dark and black, respectively, and died the following day. According to Rhazes attitude, it was malignant measles. Meyerhof in his book has referred to post-measles acute glomerulonephritis, but more appropriate differential diagnoses are compatible with this patient.
One of the best diagnoses for this case can be Weil's syndrome. Presence of fever, icterus, hemorrhage and renal injury, all suggest Weil's syndrome without pulmonary involvement. The other probable diagnosis is thrombotic thrombocytopenic purpura (TTP). Meningococcal sepsis is the other possible diagnosis.
To sum up, as three compatible diseases with the case; have been described more than a thousand years after Rhazes (Weil's syndrome 1886, TTP 1925 and meningococcemia 1805); if the case is either Weil's or TTP or meningococcal sepsis, it is the first report of the disease in the world by Rhazes.
阿布·巴克尔·穆罕默德·伊本·扎卡里亚·拉齐(公元865 - 925年),在西方被称为“拉齐斯”,是中世纪著名的科学家。他有200多部书籍和论文。他的医学杰作《》包含约900个病例报告。一些看似近期报道的疾病此前已有提及,但描述并不详尽。结合当时所描述的患者症状,将讨论鉴别诊断。
拉齐斯描述了一名患有胆汁热的患者。第四天出现血尿和便血以及疲劳症状。随后,患者的尿液和粪便颜色分别变为深色和黑色,并于次日死亡。按照拉齐斯的看法,这是恶性麻疹。迈耶霍夫在其书中提到了麻疹后急性肾小球肾炎,但更合适的鉴别诊断与该患者情况相符。
该病例的最佳诊断之一可能是韦尔综合征。发热、黄疸、出血和肾损伤的存在,均提示无肺部受累的韦尔综合征。另一个可能的诊断是血栓性血小板减少性紫癜(TTP)。脑膜炎球菌败血症是另一种可能的诊断。
综上所述,由于这三种与该病例相符的疾病;是在拉齐斯之后一千多年才被描述(韦尔综合征1886年、TTP 1925年、脑膜炎球菌血症1805年);如果该病例是韦尔综合征、TTP或脑膜炎球菌败血症,那么这是拉齐斯在世界上对该疾病的首次报道。