Clark Ashley B, Chandrasekar Indira, Nickleson Jennee
1 Department of Pharmacy Services, Valley Children's Hospital, Madera, CA, USA.
J Pharm Pract. 2018 Apr;31(2):167-168. doi: 10.1177/0897190017705811. Epub 2017 Apr 26.
A term newborn presented with widespread cutaneous erythematous to bluish lesions since birth. He had extensive lesions in the gastrointestinal tract, brain, retina, heart, and bones. He also developed an intestinal perforation due to erosion of an intestinal lesion. Due to his critical status and clinical presentation, he was initially diagnosed with multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT), and sirolimus treatment was initiated. Sirolimus was given by buccal route in this nonfeeding patient. Therapeutic serum levels were obtained comparable to enteral administration. Buccal mucosa was an effective novel route of sirolimus administration in this patient.
一名足月儿自出生以来就出现广泛的皮肤红斑至蓝色病变。他在胃肠道、脑、视网膜、心脏和骨骼均有广泛病变。他还因肠道病变糜烂而发生肠穿孔。由于其危急状况和临床表现，他最初被诊断为伴有血小板减少的多灶性淋巴管内皮瘤病（MLT），并开始使用西罗莫司治疗。在这名无法经口喂养的患者中，通过颊部途径给予西罗莫司。获得了与肠内给药相当的治疗性血清水平。颊黏膜是该患者使用西罗莫司给药的一种有效的新途径。
