Patra Kamakshya P, Scott L Keith
Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
JOP. 2011 Jan 5;12(1):40-3.
Thrombocytopenia associated multiple organ failure is a rare but increasingly recognized condition in children. Diabetic ketoacidosis preceding thrombocytopenia associated multiple organ failure is previously unreported in pediatric patients.
A 12-year-old female presented with diabetic ketoacidosis along with acute pancreatitis. She further developed thrombocytopenia and renal failure over the next two days. Although hemolytic uremic syndrome/thrombotic thrombocytopenic purpura spectrum was considered, the clinical picture seemed most consistent with thrombocytopenia associated multiple organ failure. The patient was treated with serial therapeutic plasma exchanges and made a complete recovery.
A high index of suspicion of thrombocytopenia associated multiple organ failure is required in patients with diabetic ketoacidosis or pancreatitis who present with thrombocytopenia and renal failure. Plasma exchange is a life-saving intervention in such cases.
血小板减少相关的多器官功能衰竭在儿童中是一种罕见但越来越被认识到的病症。血小板减少相关的多器官功能衰竭之前在糖尿病酮症酸中毒之前发生的情况在儿科患者中尚未有报道。
一名12岁女性出现糖尿病酮症酸中毒以及急性胰腺炎。在接下来的两天里，她进一步出现了血小板减少和肾衰竭。尽管考虑了溶血尿毒症综合征/血栓性血小板减少性紫癜谱系，但临床表现似乎最符合血小板减少相关的多器官功能衰竭。该患者接受了系列治疗性血浆置换并完全康复。
对于出现血小板减少和肾衰竭的糖尿病酮症酸中毒或胰腺炎患者，需要高度怀疑血小板减少相关的多器官功能衰竭。在这种情况下，血浆置换是一种挽救生命的干预措施。
