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小儿典型溶血尿毒综合征合并孤立性小脑梗死 1 例报告并文献复习

Isolated cerebellar stroke in a paediatric patient with typical haemolytic uraemic syndrome: a case report and literature review.

机构信息

Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

出版信息

Neuroradiology. 2024 Oct;66(10):1859-1865. doi: 10.1007/s00234-024-03407-x. Epub 2024 Jun 26.

Abstract

Haemolytic Uraemic Syndrome (HUS) is a rare medical condition characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. Neurological complications are documented but rarely involve the cerebellum. We present a unique case of a 23-month-old male with HUS triggered by Escherichia coli-O157 (E.coli-O157) infection leading to an isolated cerebellar stroke.The patient initially presented with fever, bloody stools, and seizures. Confirmation of E.coli-O157 infection was obtained, and MRI revealed an isolated cerebellar stroke. Treatment included supportive care, anticoagulation for a right atrial thrombus, with gradual improvement observed.This case highlights the unusual occurrence of isolated cerebellar stroke in HUS patients, emphasising the importance of promptly recognizing manifestations of the central nervous system and the necessity for a multidisciplinary approach. Finally, a comprehensive literature review was conducted to identify cases of HUS patients with cerebellar involvement.

摘要

溶血性尿毒综合征(HUS)是一种罕见的医学病症,其特征为微血管病性溶血性贫血、血小板减少和急性肾损伤。神经系统并发症已有记录,但很少涉及小脑。我们报告了一例独特的 23 个月大男性病例,其由大肠杆菌 O157(E.coli-O157)感染引发的 HUS 导致孤立性小脑卒中。该患者最初表现为发热、血便和癫痫发作。大肠杆菌 O157 感染得到了确认,MRI 显示孤立性小脑卒中。治疗包括支持性护理、右心房血栓的抗凝治疗,观察到逐渐改善。本病例突出了 HUS 患者中孤立性小脑卒中的罕见发生,强调了及时识别中枢神经系统表现的重要性以及多学科方法的必要性。最后,进行了全面的文献复习,以确定伴有小脑受累的 HUS 患者的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11424696/8b4bcbb6ac77/234_2024_3407_Fig1_HTML.jpg

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