登革热病例中对皮质类固醇有反应的持续性血小板减少症
Corticosteroid responsive prolonged thrombocytopenia in a case of dengue fever.
作者信息
Verma Shailendra Prasad, Hamide Abdoul, Wadhwa Jyoti, Sivamani Kalaimani
机构信息
Division of Clinical Haematology, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research JIPMER, Pondicherry, India.
出版信息
BMJ Case Rep. 2013 Aug 26;2013:200249. doi: 10.1136/bcr-2013-200249.
Thrombocytopenia and bleeding manifestations are consistent features of dengue fever. Usually thrombocytopenia resolves and platelet count normalises by day 10 of fever. Persistent thrombocytopenia is not a feature of dengue fever. Proposed mechanisms behind thrombocytopenia are many. Direct platelet destruction by dengue virus, immune-mediated platelet destruction and even megakaryocytic immune injury have been proposed as underlying mechanisms. We are reporting a case of an old man who presented in dengue season in 2012 with fever and bleeding and was diagnosed as a case of dengue fever. He developed persistent thrombocytopenia requiring treatment on the lines of immune thrombocytopenia and responded to steroids. Other causes of thrombocytopenia were ruled out.
血小板减少和出血表现是登革热的常见特征。通常，血小板减少在发热第10天时会缓解，血小板计数恢复正常。持续性血小板减少并非登革热的特征。血小板减少背后的潜在机制众多。登革病毒直接破坏血小板、免疫介导的血小板破坏甚至巨核细胞免疫损伤都被认为是潜在机制。我们报告一例老年男性病例，该患者于2012年登革热季节出现发热和出血症状，被诊断为登革热。他出现了持续性血小板减少，需要按照免疫性血小板减少的治疗方案进行治疗，且对类固醇治疗有反应。排除了其他导致血小板减少的原因。
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