Doctor: It's reasonable to perform surgery on yourself.

The treatment of autoimmune hemolytic anemia is precisely prednisone, cyclophosphamide and other drugs.

And prednisone is a glucocorticoid.

Cyclophosphamide is an immunosuppressant.

After Wei Ding diagnosed lupus cerebral, Xu Qiu immediately gave glucocorticoid + immunosuppressant, and the treatment method is extremely similar to autoimmune hemolytic anemia... After applying the treatment drug for autoimmune hemolysis, autoimmune hemolysis occurred instead?

This is impossible to happen no matter how you think about it...

Therefore, this speculation can also be directly overturned.

"Are you still handing over the shift?"

At this moment, a pleasant female voice sounded outside the conference room.

Everyone looked at the same time, and Dr. Gu from the laboratory department was standing at the door with a report in his hand.

"Doctor Xu, the results are out. We did the qualitative test as you requested, and we really found sibutramine in the urine..."

She handed the list to Xu Qiu. "Sibutramine", "norsibutramine" and "desmethylsibutramine" were all positive, but other toxic indicators were not marked.

"Sibutramine?"

Director Shen and others looked at each other in bewilderment.

A few years ago, there was a period of time when weight loss drugs were very popular. Hospitals frequently received patients with chest pain, chest tightness, and palpitations. When an electrocardiogram was taken, pathological manifestations such as arrhythmia and ventricular fibrillation were often found. After further investigation, some people had myocardial ischemia, and the more serious ones even had myocardial infarction.

Moreover, it was not unique to a certain hospital or certain regions, but was scattered throughout the country and became more and more serious.

Later, the state stepped in, and the National Health Commission also dispatched an expert group to investigate, and finally locked in a drug - sibutramine.

The State Food and Drug Administration immediately included it in the list of prohibited production, sales and use. In the same year, it appeared in the "List of Materials that May be Illegal Additions in Health Foods (First Batch)" and was classified as "toxic and harmful non-food raw materials."

So far, this popular online celebrity weight loss drug has been completely banned for increasing the risk of serious cardiovascular disease and even causing stroke and death.

"In this case, the patient's heart failure can be explained."

"However, according to literature records, sibutramine only increases the risk of heart disease, mainly affecting cardiovascular and blood pressure, etc. What does it have to do with the patient's acute liver injury?"

"The hepatotoxicity of sibutramine is not clear, but it has experienced the drug ban storm before, and various sequelae must have been listed. Not mentioning it means that it is similar to other drugs. Even if it is taken in excess, it is difficult to cause acute liver damage..."

Doctors put forward their own views.

The emergence of sibutramine gave them a new direction, but it still did not explain the many doubts about Weiding.

Instead, it brought more confusion...

"Doctor Xu, I also brought samples sent by the patient's family for inspection." Doctor Gu said.

She took out a dust-free bag from her white coat, which contained a green-packaged powder.

"This is the green vegetable fiber enzyme he is selling... It's not written in the instructions, but after testing, sibutramine was indeed found."

Xu Qiu nodded and breathed a sigh of relief.

The information he checked last night was not in vain, and the truth was revealed.

"However, there is another question, how did the anemia come about?"

Xu Qiu didn't think of the reason.

The enlarged heart shadow is a manifestation of chronic anemia, not the cause.

Similarly, even if sibutramine can lead to increased cardiovascular risk, Xu Qiu has sorted out the pathogenesis, but anemia can never find an answer.

The most common symptom for ordinary people is malnutrition.

But Wei Ding is obese, and many doctors will subconsciously rule this out.

Xu Qiu carefully analyzed it.

The poor complexion can be explained by the disease, but Wei Ding's dry and brittle hair and dull, thin and soft nails are the intuitive manifestations of malnutrition.

But Xu Qiu has no evidence.

At this moment, Dr. Gu reached into her pocket again, "Dr. Xu, there's this."

Everyone was slightly stunned. Are you Doraemon? Can you take it all out at once?

Xu Qiu's eyes fell on the item in Dr. Gu's hand, which was a small bag of meal replacement oatmeal.

"This..."

Without waiting for Xu Qiu to ask, Dr. Gu explained: "When I went to get the sample, the patient told me that he sells a lot of things, including this green weight loss product, meal replacement products, and some shampoo and so on."

After a pause, she suddenly looked serious and said, "Basically, they are all three-no products."

Xu Qiu noticed the word meal replacement.

He asked sharply: "What does the patient usually eat?"

Dr. Gu looked at Wang Fan.

It was Xiao Wang who was on duty last night, and this patient was also Wang Fan's supervisor.

Wang Fan said repeatedly: "He used all his money to buy goods, and the public space in the dormitory almost became his warehouse. He basically used the products he sold for food and clothing, and usually ate meal replacements and the enzymes in the green package."

Xu Qiu finally came to a conclusion in his heart when he heard this: "Malnutrition."

So far, all the mysteries have been solved.

"It was not acute liver damage, anemia, heart failure, etc. that induced the patient's acute and severe illness last night." Xu Qiu spoke loudly.

Everyone immediately pricked up their ears.

At the same time, they were full of doubts.

It turned out not to be?

In addition to these most critical indicators, what else can make the patient fall into the gates of hell in a short period of time?

"Respiratory alkalosis." Xu Qiu said concisely.

Director Shen and others showed astonishment on their faces, and Wang Ping, He Hai and others were also shocked.

This disease is more common in girls. Women who have broken up with their lover cry loudly, which leads to hyperventilation, causing a large amount of carbon dioxide to be discharged from the body, thus causing respiratory alkalosis. The symptoms are generally not too serious. The milder ones are just shortness of breath and increased heart rate. Even if they are more serious, they are just dizziness and convulsions.

Respiratory alkalosis can indeed be combined with metabolic acidosis, because the patient's heart and lungs have underlying diseases. However, this common disease, which can be relieved by covering the lips with a mask and letting the patient inhale the exhaled gas to replenish the carbon dioxide in the body, how can it induce such a terrible severe disease?

"Another point, how can the patient have respiratory alkalosis for no reason..." Director Shen was puzzled.

The essence of respiratory alkalosis is hyperventilation, which leads to the discharge of a large amount of carbon dioxide.

There are many reasons for hyperventilation.

For example, it may happen when you cry loudly after a breakup and are out of breath.

In addition, the most common is mental hyperventilation, and there is also secondary increase in ventilation caused by hyperthyroidism or fever; hypoxia is to compensate for hypoxia at the cost of hyperventilation, etc.

Generally speaking, diseases of the central nervous system, such as meningitis, encephalitis, etc., may also stimulate the respiratory center and excite breathing. Lupus brain theoretically also has this probability, but there is a premise in front of everyone-

Xu Qiu has already given a perfect treatment plan, and the subsequent results also proved that the patient's lupus brain condition has been controlled and alleviated. How could it lead to respiratory alkalosis?