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治疗性血浆置换在登革热相关微血管病中的作用。

Role of therapeutic plasma exchange in dengue-related microangiopathy.

作者信息

Sahni Aarushi, Wadhera Sarthak, Lamba Divjot Singh, Hans Rekha, Jain Arihant, Malhotra Pankaj, Sharma Ratti Ram

机构信息

Department of Transfusion Medicine, PGIMER, Chandigarh, India.

Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, India.

出版信息

Asian J Transfus Sci. 2025 Jan-Jun;19(1):163-166. doi: 10.4103/ajts.ajts_227_23. Epub 2024 Aug 22.

Abstract

Thrombotic microangiopathies (TMAs) are a group of disorders characterized by microangiopathic hemolytic anemia and thrombocytopenia, leading to ischemic tissue injury. We, hereby, describe an interesting case of TMA secondary to dengue along with dengue encephalitis. Dengue-related TMA is rarely described. Treatment was initiated with standard-volume (1.5 plasma volume) therapeutic plasma exchange (TPE) by centrifugation method on a multifunctional cell separator (Spectra Optia, Terumo BCT, USA) within a few hours of admission based on high PLASMIC score, which led to improvement in hemolytic parameters and kidney injury. This case highlights the role of early diagnosis and early initiation of TPE is key in the management of dengue-related TMAs.

摘要

血栓性微血管病(TMAs)是一组以微血管病性溶血性贫血和血小板减少为特征的疾病,可导致缺血性组织损伤。在此,我们描述了一例继发于登革热及登革热脑炎的血栓性微血管病的有趣病例。与登革热相关的血栓性微血管病鲜有报道。基于高PLASMIC评分,患者入院后数小时内即采用多功能细胞分离仪(美国Terumo BCT公司的Spectra Optia)通过离心法进行标准量(1.5个血浆量)的治疗性血浆置换(TPE),这使得溶血参数和肾损伤得到改善。该病例突出了早期诊断的作用,且早期启动TPE是登革热相关血栓性微血管病管理的关键。

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