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小儿木样结膜炎治疗中的联合药物与手术方法:一例报告

Combined medical and surgical approach in the management of ligneous conjunctivitis in a pediatric patient: A case report.

作者信息

Ahmad Abdullah K, Alhamdan Faisal G, Sadiq Mohammad

机构信息

Department of Ophthalmology, Abdulrahman Albahar Eye Center, Ibn Sina Hospital, Kuwait.

Department of Ophthalmology, Abdulrahman Albahar Eye Center, Ibn Sina Hospital, Kuwait.

出版信息

Int J Surg Case Rep. 2023 Sep;110:108568. doi: 10.1016/j.ijscr.2023.108568. Epub 2023 Jul 27.

DOI:10.1016/j.ijscr.2023.108568
PMID:37639967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10509789/
Abstract

INTRODUCTION

Ligneous conjunctivitis (LC), a rare chronic conjunctivitis linked to plasminogen deficiency, poses challenges in research and management due to its complexity. This case report details the combined medical and surgical approach in managing LC in a 1.5-year-old female with congenital hydrocephalus, plasminogen deficiency, and glaucoma.

CASE PRESENTATION

The patient's LC required a comprehensive treatment plan involving systemic and topical therapies, surgical intervention, and fresh frozen plasma (FFP) infusions via a central line.

DISCUSSION

Managing LC necessitates a comprehensive, individualized approach due to its rarity and lack of standardized treatments. Various therapies have shown promise, but their availability, cost, and potential side effects vary. FFP infusions played a crucial role in managing plasminogen deficiency, but the potential complications associated with central lines must be considered. Ongoing clinical trials aim to improve LC treatment, but until results are available, clinicians must rely on existing evidence and clinical judgment.

CONCLUSION

This case underscores the complexity of managing LC and the significance of adopting an individualized treatment strategy. Regular follow-ups are crucial for flexibility and adaptability in treatment plans to address potential recurrences. Further research is necessary to validate these findings and assess the long-term effectiveness of the combined approach.

摘要

引言

木质化性结膜炎(LC)是一种与纤溶酶原缺乏相关的罕见慢性结膜炎,因其复杂性给研究和管理带来挑战。本病例报告详细介绍了一名患有先天性脑积水、纤溶酶原缺乏和青光眼的1.5岁女性患者LC的综合药物和手术治疗方法。

病例介绍

患者的LC需要一个综合治疗方案,包括全身和局部治疗、手术干预以及通过中心静脉导管输注新鲜冷冻血浆(FFP)。

讨论

由于LC罕见且缺乏标准化治疗方法,因此对其进行管理需要采取全面、个性化的方法。各种治疗方法都显示出了前景,但它们的可及性、成本和潜在副作用各不相同。FFP输注在管理纤溶酶原缺乏方面发挥了关键作用,但必须考虑与中心静脉导管相关的潜在并发症。正在进行的临床试验旨在改善LC的治疗,但在结果出来之前,临床医生必须依靠现有证据和临床判断。

结论

本病例强调了管理LC的复杂性以及采用个性化治疗策略的重要性。定期随访对于治疗计划的灵活性和适应性至关重要,以应对潜在的复发情况。需要进一步研究来验证这些发现并评估联合治疗方法的长期有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/58d22afa9a59/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/702f8609486a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/94c6e2a56418/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/8334a60aac38/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/ab771eaeb587/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/58d22afa9a59/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/702f8609486a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/94c6e2a56418/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/8334a60aac38/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/ab771eaeb587/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/10509789/58d22afa9a59/gr5.jpg

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本文引用的文献

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Treatment of Ligneous Conjunctivitis with Plasminogen Eyedrops.用纤溶酶原滴眼液治疗木样结膜炎。
Ophthalmology. 2022 Aug;129(8):955-957. doi: 10.1016/j.ophtha.2022.03.019. Epub 2022 Mar 26.
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First Treatment for Plasminogen Deficiency Is Approved.纤溶酶原缺乏症的首个治疗方法获批。
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The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines.SCARE 2020 指南:更新共识手术病例报告(SCARE)指南。
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Amniotic membrane transplantation for ligneous conjunctivitis in a doberman.杜宾犬木样结膜炎的羊膜移植术
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Plasminogen replacement therapy for the treatment of children and adults with congenital plasminogen deficiency.纤溶酶原替代疗法治疗先天性纤溶酶原缺乏症的儿童和成人。
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Treatment of plasminogen deficiency patients with fresh frozen plasma.用新鲜冷冻血浆治疗纤溶酶原缺乏症患者。
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Topical Plasminogen as Adjunctive Treatment in Recurrent Ligneous Conjunctivitis.局部应用纤溶酶原作为复发性木样结膜炎的辅助治疗
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Successful treatment of ligneous conjunctivitis with topical fresh frozen plasma in an infant.局部应用新鲜冷冻血浆成功治疗婴儿木样结膜炎。
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Identification of three novel plasminogen (PLG) gene mutations in a series of 23 patients with low PLG activity.在 23 例低 PLG 活性患者的一系列研究中鉴定出三个新型纤溶酶原(PLG)基因突变。
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