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蜈蚣毒液和乙二胺四乙酸(EDTA)导致一名11岁女孩假性血小板减少症的潜在影响。

The Potential Effects of Centipede Venom and Ethylenediaminetetraacetic Acid (EDTA) Leading to Pseudothrombocytopenia in an 11-Year-Old Girl.

作者信息

Egbert Nikita N, Rangwala Umme Salma, David Andrew, Sugadev Vivek, Koshy Alan V

机构信息

Pediatric Emergency Medicine, Christian Medical College, Vellore, IND.

Pediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, IND.

出版信息

Cureus. 2025 Apr 23;17(4):e82822. doi: 10.7759/cureus.82822. eCollection 2025 Apr.

Abstract

Centipede bites are uncommon and mostly occur in subtropical regions. While most cases present with local swelling and tenderness around the bite site, with few systemic manifestations, the potential complications can be deadly. This case describes an unusual presentation of a centipede bite, in which the patient experienced an unexpected fluctuation in platelet counts, which occurred up to weeks after the bite. While the cause remains unclear, we question whether this occurred solely due to the direct effects of the centipede venom or if there were other factors at play. The aim of this report is to explore the possible differentials. Most importantly, we shed light on a plausible but often overlooked cause of thrombocytopenia; ethylenediaminetetraacetic acid-induced pseudothrombocytopenia, the anticoagulant present in blood sample collection tubes. Similar cases have yet to be reported to our knowledge. Physicians must maintain a high degree of suspicion when facing unexplained thrombocytopenia in clinical practice.

摘要

蜈蚣咬伤并不常见,主要发生在亚热带地区。虽然大多数病例表现为咬伤部位周围局部肿胀和压痛,全身表现较少,但潜在并发症可能是致命的。本病例描述了蜈蚣咬伤的一种不寻常表现,患者在咬伤后数周内血小板计数出现意外波动。虽然原因尚不清楚,但我们质疑这是否仅由蜈蚣毒液的直接作用引起,还是有其他因素在起作用。本报告的目的是探讨可能的鉴别诊断。最重要的是,我们揭示了血小板减少症一个看似合理但常被忽视的原因;乙二胺四乙酸诱导的假性血小板减少症,即血液样本采集管中存在的抗凝剂。据我们所知,类似病例尚未见报道。临床医生在面对临床实践中无法解释的血小板减少症时必须保持高度怀疑。

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