Fluri Simon, Kaczala Gregor W, Leibundgut Kurt, Alberio Lorenzo
Division of Paediatric Intensive Care, Children's University Hospital Berne, Berne, Switzerland.
Pediatr Emerg Care. 2010 Dec;26(12):932-4. doi: 10.1097/PEC.0b013e3181fe91cd.
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.
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。