Nimmannitya S, Thisyakorn U, Hemsrichart V
Children's Hospital, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 1987 Sep;18(3):398-406.
A retrospective study on 18 cases of DHF presented with jaundice and neurological signs which were considered unusual manifestation of DHF reveals that the causes or contributing factors are multifactorial. Most commonly found associated conditions were prolonged shock with metabolic acidosis and severe DIC that lead to hypoxia/ischaemia and resulted in both hepatic and brain dysfunction. Gross haemorrhage in the brain was noted in 6 of the 10 fatal cases while brain oedema was noted in 3 cases. Electrolyte disturbance such as hyponatremia could be another cause of brain oedema. It is certain from this study that there is no pathological evidence of encephalitis. Hepatic dysfunction found in associated with jaundice and encephalopathy is possibly caused by toxic substances, drugs and/or associated with underlying liver conditions. Reye's or Reye's-like syndrome was postulated in one case.
一项针对18例伴有黄疸和神经症状的登革出血热（DHF）病例的回顾性研究显示，这些被认为是DHF不寻常表现的病因或促成因素是多方面的。最常见的相关情况是伴有代谢性酸中毒的长时间休克和严重的弥散性血管内凝血（DIC），这导致缺氧/缺血，进而引起肝和脑功能障碍。10例致命病例中有6例出现脑内大出血，3例出现脑水肿。低钠血症等电解质紊乱可能是脑水肿的另一个原因。从这项研究可以确定，没有脑炎的病理证据。与黄疸和脑病相关的肝功能障碍可能是由有毒物质、药物和/或潜在的肝脏疾病引起的。有一例推测为瑞氏或类瑞氏综合征。
