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病例报告:一名儿科患者通过体外膜肺氧合和免疫抑制成功治疗严重显微镜下多血管炎。

Case report: severe microscopic polyangiitis successfully treated with extracorporeal membrane oxygenation and immunosuppression in a pediatric patient.

作者信息

Di Maria Michael V, Hollister Roger, Kaufman Jon

机构信息

Department of Pediatrics, University of Colorado at Denver Health Sciences Center, The Children's Hospital of Denver, Aurora, Colorado, USA.

出版信息

Curr Opin Pediatr. 2008 Dec;20(6):740-2. doi: 10.1097/MOP.0b013e3283168e44.

Abstract

Severe microscopic polyangiitis can result in acute respiratory failure and renal failure and is commonly treated with mechanical cardiopulmonary support, along with immunosuppression. We report the use of continuous renal replacement therapy and rituximab in a 13-year-old boy with P-antineutrophil cytoplasmic antibody-positive microscopic polyangiitis, resulting in pulmonary hemorrhage and acute renal failure. The patient was treated with high-frequency oscillatory ventilation, extracorporeal membrane oxygenation, and continuous renal replacement therapy, in addition to plasmapheresis, corticosteroids, cyclophosphamide, and rituximab.

摘要

重症显微镜下多血管炎可导致急性呼吸衰竭和肾衰竭,通常采用机械心肺支持及免疫抑制治疗。我们报告了一名13岁抗中性粒细胞胞浆抗体阳性的显微镜下多血管炎男孩,采用持续肾脏替代治疗和利妥昔单抗治疗,出现了肺出血和急性肾衰竭。除血浆置换、皮质类固醇、环磷酰胺和利妥昔单抗外,该患者还接受了高频振荡通气、体外膜肺氧合和持续肾脏替代治疗。

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