Leoz Gordillo I, Pérez Suárez E
Servicio Urgencias, Hospital Infantil Universitario Niño Jesús, Madrid, España.
Servicio Urgencias, Hospital Infantil Universitario Niño Jesús, Madrid, España.
An Pediatr (Barc). 2015 Jan;82(1):e102-7. doi: 10.1016/j.anpedi.2013.12.014. Epub 2014 Mar 12.
Anemic syndrome in childhood requires a diagnosis and urgent treatment guided by systematic protocols that can avoid unnecessary additional testing. The case of a 4 year-old girl with fatigue and intermittent fever of 7 days duration, accompanied by abdominal pain is presented. She had regular general health status, with mucocutaneous jaundice, a grade III/VI/iv murmur, and painful abdomen with hepatosplenomegaly. The blood analysis showed a hypo-regenerative anemia with increased LDH and indirect bilirubin. The Coombs Test was negative, with spherocytes being observed in the peripheral blood smear. The IgM and IgG were positive for parvovirus B19 IgM and Epstein Barr virus, leading to the diagnosis of aplastic crisis in a patient with hereditary spherocytosis. No specific treatment was required. Under the suspicion of anemic syndrome in emergencies, the ABCDE sequence must be followed. Through the history, physical examination and basic laboratory tests, an initial diagnostic approach can be made. Specific etiological tests should be based on this first study.
儿童贫血综合征需要依据系统方案进行诊断和紧急治疗，这些方案可避免不必要的额外检查。本文介绍了一名4岁女童的病例，该女童疲劳且持续发热7天，伴有腹痛。她的一般健康状况正常，有黏膜皮肤黄疸、三级/六级/四级杂音，以及伴有肝脾肿大的腹痛。血液分析显示为低增生性贫血，乳酸脱氢酶和间接胆红素升高。库姆斯试验呈阴性，在外周血涂片上观察到球形红细胞。IgM和IgG对细小病毒B19 IgM和爱泼斯坦-巴尔病毒呈阳性，从而诊断为一名遗传性球形红细胞增多症患者发生再生障碍危象。无需特殊治疗。在怀疑紧急情况下的贫血综合征时，必须遵循ABCDE顺序。通过病史、体格检查和基础实验室检查，可以进行初步诊断。具体的病因检查应基于这一初步研究。
