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无肝外铁沉积的新生儿血色素沉着症的静脉注射免疫球蛋白成功治疗:病例报告

Successful IVIG Treatment in Neonatal Hemochromatosis Without Extrahepatic Siderosis: A Case Report.

作者信息

Lim Gwan Yong, Thashin Ashta, Joy Gayathri, Cheyne Ithamar, Mikaszewska-Sokolewicz Małgorzata

机构信息

Anesthesiology and Intensive Care Scientific Circle, Medical University of Warsaw, 02-091 Warsaw, Poland.

Clinic of Anesthesiology and Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.

出版信息

Reports (MDPI). 2025 Apr 23;8(2):53. doi: 10.3390/reports8020053.

Abstract

: Neonatal hemochromatosis is a rare iron overload disorder that causes severe liver injury in newborns, typically with extrahepatic siderosis. Diagnosis of neonatal hemochromatosis is usually confirmed through a biopsy and MRI, demonstrating deposition of iron and liver failure. However, in severe patients who are not able to undergo biopsy, the diagnostic and management method remains unknown. : We present an unusual case of neonatal hemochromatosis without extrahepatic iron deposition in a 9-day-old male who showed signs of liver failure and respiratory distress. This case suggests that when the risks of biopsy outweigh its benefits, a diagnosis may be reached based on clinical evaluation and MRI findings. Early high-dose intravenous immunoglobulin therapy improved liver function and led to recovery, highlighting the need for early therapeutic intervention in neonatal hemochromatosis. : This case highlights that the absence of extrahepatic siderosis cannot exclude a diagnosis of neonatal hemochromatosis, and high doses of IVIG should be administered promptly when neonatal hemochromatosis is suspected to maximize therapeutic effectiveness.

摘要

新生儿血色沉着症是一种罕见的铁过载疾病,可导致新生儿严重肝损伤,通常伴有肝外铁沉积。新生儿血色沉着症的诊断通常通过活检和磁共振成像(MRI)来确认,表现为铁沉积和肝功能衰竭。然而,对于无法进行活检的重症患者,诊断和管理方法仍不明确。

我们报告了一例9日龄男性新生儿血色沉着症的罕见病例,该患儿无肝外铁沉积,但出现肝功能衰竭和呼吸窘迫迹象。该病例表明,当活检风险大于其益处时,可根据临床评估和MRI结果做出诊断。早期大剂量静脉注射免疫球蛋白治疗改善了肝功能并实现康复,凸显了对新生儿血色沉着症进行早期治疗干预的必要性。

该病例突出表明,肝外无铁沉积不能排除新生儿血色沉着症的诊断,当怀疑新生儿血色沉着症时,应及时给予大剂量静脉注射免疫球蛋白,以最大限度提高治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8299/12196930/15a8c9d6ecb0/reports-08-00053-g001.jpg

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