与沙眼衣原体感染相关的严重腹膜炎和亚临床播散性血管内凝血

Advanced peritonitis and subclinical disseminated intravascular coagulopathy associated with Chlamydia trachomatis infection.

作者信息

Tsukada Y, Tamura S, Mitsuhashi H, Ueki K, Maezawa A, Nojima Y

机构信息

The Third Department of Internal Medicine, Gunma University School of Medicine, Japan.

出版信息

Scand J Infect Dis. 2001;33(7):555-7. doi: 10.1080/00365540110026601.

DOI:10.1080/00365540110026601

PMID:11515772

Abstract

A 29-y-old woman was admitted to our hospital complaining of slight fullness of the lower abdomen. Ultrasound echographic study and magnetic resonance imaging showed pleural effusion and pelvic ascites. Laboratory investigation revealed anemia and thrombocytopenia (hemoglobin 6 mmol/l; platelets 7 x 10(10)/l), remarkable polyclonal hypergammopathy (gamma immunoglobulin 7.7 g/dl) and subclinical disseminated intravascular coagulopathy (DIC). By laparoscopy, extensive adhesion of the peritoneum and bilateral ovarian tubes was observed. From the appearance of adhesion, we suspected Chlamydia trachomatis infection and performed serologic and molecular studies. Administration of clarithromycin resolved hypergammopathy, DIC and ascites.

摘要

一名29岁女性因下腹部轻度胀满入住我院。超声心动图检查和磁共振成像显示有胸腔积液和盆腔腹水。实验室检查发现贫血和血小板减少（血红蛋白6 mmol/l；血小板7×10¹⁰/l）、显著的多克隆高球蛋白血症（γ免疫球蛋白7.7 g/dl）以及亚临床弥散性血管内凝血（DIC）。通过腹腔镜检查，观察到腹膜和双侧输卵管广泛粘连。根据粘连外观，我们怀疑是沙眼衣原体感染，并进行了血清学和分子学研究。服用克拉霉素后，高球蛋白血症、DIC和腹水得到缓解。