Guerrero Carlos A, Torres Diana P, García Leidy L, Guerrero Rafael A, Acosta Orlando
Department of Physiological Sciences, Faculty of Medicine, Universidad Nacional de Colombia, Bogota, D.C, Colombia.
Pharmacotherapy. 2014 Nov;34(11):e333-40. doi: 10.1002/phar.1489. Epub 2014 Sep 24.
Rotaviruses are the leading cause of severe, acute, and dehydrating diarrhea affecting children under 5 years of age worldwide. Despite an important reduction in rotavirus-caused deaths as a consequence of the rotavirus vaccine, alternative or complementary strategies for preventing or treating rotavirus-associated diarrhea are needed mainly in the poorest countries. We describe the cases of four rotavirus-unvaccinated 12-13-month-old girls and a 5-year-old boy who developed rotavirus-associated diarrhea confirmed by enzyme-linked immunosorbent assay, Western blotting, and immunochemistry analyses. After the first day of diarrheal episodes, three of the five patients were immediately administered oral N-acetylcysteine (NAC) 60 mg/kg daily, divided into three equal doses every 8 hours. The other two patients did not receive NAC and served as controls. Administration of NAC resulted in a decreased number of diarrheal episodes, excretion of fecal rotavirus antigen, and resolution of symptoms after 2 days of treatment. Our results suggest that NAC treatment after the first diarrheal episode could be an efficient strategy for treating rotavirus-affected children and preventing the associated severe life-threatening accompanying dehydration.
轮状病毒是全球范围内导致5岁以下儿童严重、急性和脱水性腹泻的主要原因。尽管轮状病毒疫苗使轮状病毒导致的死亡人数大幅减少，但主要在最贫穷国家仍需要预防或治疗轮状病毒相关腹泻的替代或补充策略。我们描述了4名未接种轮状病毒疫苗的12 - 13个月大女孩和1名5岁男孩的病例，他们通过酶联免疫吸附测定、蛋白质印迹法和免疫化学分析确诊为轮状病毒相关腹泻。在腹泻发作的第一天后，5名患者中的3名立即每天口服60 mg/kg的N - 乙酰半胱氨酸（NAC），每8小时分成三等份剂量服用。另外两名患者未接受NAC并作为对照。服用NAC导致腹泻发作次数减少、粪便轮状病毒抗原排泄减少，并在治疗2天后症状缓解。我们的结果表明，首次腹泻发作后进行NAC治疗可能是治疗受轮状病毒感染儿童并预防相关严重危及生命的伴随脱水的有效策略。
