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[小儿癌症患者的中性粒细胞减少性小肠结肠炎]

[Neutropenic enterocolitis in the pediatric cancer patient].

作者信息

Kassisse L Jorge, Delpiano M Luis, López D Francia, Espinoza G Aníbal

机构信息

Programa Formación en Pediatría, Hospital Clínico San Borja Arriarán, Universidad de Chile, Chile.

Unidad de Infectología, Hospital Clínico San Borja Arriarán, Chile.

出版信息

Rev Chilena Infectol. 2022 Feb;39(1):59-69. doi: 10.4067/S0716-10182022000100059.

DOI:10.4067/S0716-10182022000100059
PMID:35735281
Abstract

Neutropenic enterocolitis (NEC) is a heterogeneous disease of the gastrointestinal tract with systemic response, that corresponds to a severe and life-threatening clinical condition in immunocompromised patients, especially in childhood cancer. The pathologic features are poorly understood, although its multifactorial cause of NEC is well established and it is associated with the cytotoxic effects of the chemotherapy agents used and recognized by the classic triad of fever, neutropenia, and abdominal pain, secondary to gastrointestinal injuries that alters mucosal permeability and helps intramural bacterial invasion. NEC is truly a clinical challenge that requires an early diagnosis and a multidisciplinary approach including basic laboratory and imagological tests in high complexity centers. We present a current review, adding epidemiological aspects, risks factors, diagnostic support elements, therapeutic considerations, and preventive measures in order to provide knowledge of this disease and help to reduce morbidity and mortality associated with it.

摘要

中性粒细胞减少性小肠结肠炎(NEC)是一种伴有全身反应的异质性胃肠道疾病,在免疫功能低下的患者中,尤其是儿童癌症患者中,它是一种严重的、危及生命的临床病症。尽管NEC的多因素病因已明确,且与所用化疗药物的细胞毒性作用相关,并表现为发热、中性粒细胞减少和腹痛这一经典三联征,继发于胃肠道损伤导致黏膜通透性改变并促使壁内细菌入侵,但对其病理特征仍了解不足。NEC确实是一项临床挑战,需要早期诊断以及多学科方法,包括在高复杂性中心进行基础实验室和影像学检查。我们进行了一项当前综述,补充了流行病学方面、危险因素、诊断支持要素、治疗考量及预防措施,以便提供关于该疾病的知识,并有助于降低与之相关的发病率和死亡率。

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