Rodríguez Rangel D A, Pinilla Orejarena A P, Bustacara Diaz M, Henao García L, López Cadena A, Montoya Camargo R, Moreno L A
Clínica Materno Infantil San Luis, Bucaramanga, Colombia.
Universidad Nacional de Colombia, Bogotá, Colombia.
An Pediatr (Barc). 2014 Feb;80(2):77-80. doi: 10.1016/j.anpedi.2013.04.001. Epub 2013 Jun 5.
Ceftriaxone associated pseudolithiasis is fairly frequent in children, but rarely taken into account. It occurs in 15% to 57% of children, and in most cases is asymptomatic and resolves spontaneously.
A prospective, observational, and descriptive study was conducted that included patients aged 1 month to 18 years-old who received ceftriaxone. Liver and gallbladder ultrasound was performed at the start of treatment, and every 5 days until it was completed. Patients with abnormal ultrasound findings were followed up clinically every week until they were resolved. The findings were compared with risk factors described in the literature.
A total of 73 patients aged between 4 months and 17 years (mean=4.2 years) were included, of whom 57.5% were female. Pseudolithiasis was present in 31 patients (42.5%) and was documented in 96.8% (n=30) of this group on day 5. The stone size was between 4 and 14mm (mean=8.1mm). The duration of pseudolithiasis was between 9 and 55 days (mean=24.1 days). Symptoms were present in 22.6% (n=7) and 1 had a serious complication. In the multivariate analysis, Ringer's Lactate as fluid dilution was 1.86 times higher risk (P=.019). No relationship was found with age, duration and dose of antibiotic, fasting, use of calcium supplements, parenteral nutrition, or use of other antibiotics.
Pseudocolelitiasis associated with ceftriaxone take place in 4 of 10 children who receive, unrelated to traditional risk factors. The trend is towards self resolution although about 20% have symptoms.
头孢曲松相关的假结石症在儿童中相当常见，但很少被考虑到。它在15%至57%的儿童中出现，大多数情况下无症状且可自发缓解。
进行了一项前瞻性、观察性和描述性研究，纳入了年龄在1个月至18岁接受头孢曲松治疗的患者。在治疗开始时以及治疗完成前每5天进行肝脏和胆囊超声检查。超声检查结果异常的患者每周进行临床随访直至症状缓解。将研究结果与文献中描述的危险因素进行比较。
共纳入73例年龄在4个月至17岁（平均4.2岁）的患者，其中57.5%为女性。31例患者（42.5%）出现假结石症，其中96.8%（n = 30）在第5天被记录到。结石大小在4至14毫米之间（平均8.1毫米）。假结石症持续时间在9至55天之间（平均24.1天）。22.6%（n = 7）的患者出现症状，1例出现严重并发症。在多因素分析中，乳酸林格氏液作为液体稀释剂时风险高1.86倍（P = 0.019）。未发现与年龄、抗生素使用时间和剂量、禁食、使用钙补充剂、肠外营养或使用其他抗生素之间存在关联。
接受治疗的儿童中，每10例有4例发生与头孢曲松相关的假胆石症，与传统危险因素无关。虽然约20%的患者有症状，但总体趋势是自行缓解。
