Leclerc F, Delepoulle F, Martinot A, Diependaele J F, Houque D, Hue V
Unité de réanimation infantile, Hôpital Calmette, Lille, France.
Pediatrie. 1988;43(6):545-50.
Between 1971 and 1985, 43 children died of purpura fulminans in our intensive care unit: 11 had autopsy and adrenal haemorrhage was observed in 8 (73%). All these patients had an extensive purpura and a severe disseminated intravascular coagulation. Our series confirms the findings of previous studies: 69 autopsies showed 51 cases (74%) of macroscopic adrenal haemorrhage. Adrenal haemorrhage may be only one manifestation of multiple system organ failure consecutive to septic shock; however, its association with low plasma cortisol levels (as previously reported) suggests that glucocorticoid replacement therapy should be reconsidered in purpura fulminans.
1971年至1985年间，我们重症监护病房有43名儿童死于暴发性紫癜：11名进行了尸检，其中8名（73%）观察到肾上腺出血。所有这些患者均有广泛的紫癜和严重的弥散性血管内凝血。我们的系列研究证实了先前研究的结果：69例尸检中有51例（74%）出现肉眼可见的肾上腺出血。肾上腺出血可能只是脓毒性休克后继发的多系统器官衰竭的一种表现；然而，其与低血浆皮质醇水平的关联（如先前报道）提示，对于暴发性紫癜应重新考虑糖皮质激素替代疗法。
