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水痘并非总是良性的:暴发性水痘后紫癜需要迅速且积极的治疗。

Chickenpox is not always benign: postvaricella purpura fulminans requires prompt and aggressive treatment.

作者信息

Fluri Simon, Kaczala Gregor W, Leibundgut Kurt, Alberio Lorenzo

机构信息

Division of Paediatric Intensive Care, Children's University Hospital Berne, Berne, Switzerland.

出版信息

Pediatr Emerg Care. 2010 Dec;26(12):932-4. doi: 10.1097/PEC.0b013e3181fe91cd.

Abstract

We present 2 patients, who were admitted owing to rapidly progressing purpuric lesions due to postvaricella purpura fulminans, a coagulopathy leading to life- or limb-threatening thrombosis caused by a severe transient autoimmune protein S deficiency. Laboratory results were being consistent with disseminated intravascular coagulation secondary to protein S deficiency; treatment with fresh frozen plasma, intravenous immunoglobulins, and prednisone was started. In our experience, a prompt therapy may limit the course and the extent of the disease. We present a review of the topic with supporting literature for the therapeutic options. Therefore, we should be reminded that purpura fulminans is a rare but severe complication of chickenpox, which demands quick action.

摘要

我们报告了2例患者,他们因水痘后暴发性紫癜导致紫癜性病变迅速进展而入院,这是一种由严重短暂性自身免疫性蛋白S缺乏引起的凝血病,可导致危及生命或肢体的血栓形成。实验室结果与蛋白S缺乏继发的弥散性血管内凝血一致;开始使用新鲜冰冻血浆、静脉注射免疫球蛋白和泼尼松进行治疗。根据我们的经验,及时治疗可能会限制疾病的病程和范围。我们对该主题进行了综述,并提供了支持治疗选择的文献。因此,我们应谨记暴发性紫癜是水痘的一种罕见但严重的并发症,需要迅速采取行动。

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