一例由甲型流感病毒引起的瑞氏综合征病例。
A Case of Reye Syndrome Caused by Influenza A Virus.
作者信息
Noor Abdullah, Gradidge Eleanor
机构信息
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Department of Pediatrics, Ochsner Clinic Foundation, New Orleans, LA.
出版信息
Ochsner J. 2018 Winter;18(4):425-427. doi: 10.31486/toj.18.0098.
BACKGROUND
Reye syndrome is a rare and potentially life-threatening disease characterized by liver failure and hepatic encephalopathy. Multiple possible etiologies have been suggested, but only aspirin (acetylsalicylic acid) has been statistically proven to be a causative factor. We describe a case of Reye syndrome secondary to influenza A virus.
CASE REPORT
A 2-year-old male with a recent history of influenza-like symptoms presented with neurologic deterioration. He had elevated liver enzymes, hyperammonemia, elevated creatinine, and hypoglycemia. Liver biopsy showed microvesicular steatosis consistent with Reye syndrome. He was given supportive care and recovered after 17 days with normalization of metabolic derangements. At 4-month follow-up, the patient had reached age-specific developmental milestones.
CONCLUSION
The incidence of Reye syndrome has decreased since 1980 when the Centers for Disease Control and Prevention issued a warning against aspirin use in children. Consequently, any new incidence of Reye syndrome warrants investigation of other etiologies. This case adds to the evidence that causes other than aspirin can result in Reye syndrome.
背景
瑞氏综合征是一种罕见且可能危及生命的疾病，其特征为肝功能衰竭和肝性脑病。虽然已经提出了多种可能的病因，但只有阿司匹林（乙酰水杨酸）在统计学上被证明是一个致病因素。我们报告一例甲型流感病毒继发的瑞氏综合征病例。
病例报告
一名2岁男性，近期有流感样症状病史，出现神经功能恶化。他有肝酶升高、高氨血症、肌酐升高和低血糖。肝活检显示微泡性脂肪变性，符合瑞氏综合征。给予支持治疗，17天后代谢紊乱恢复正常，患者康复。在4个月的随访中，患者达到了特定年龄的发育里程碑。
结论
自1980年疾病控制和预防中心发布关于儿童使用阿司匹林的警告以来，瑞氏综合征的发病率有所下降。因此，瑞氏综合征的任何新发病例都需要对其他病因进行调查。该病例进一步证明，除阿司匹林外的其他病因也可导致瑞氏综合征。
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