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HIV免疫缺陷患者肝素诱导的血小板减少症的诊断和治疗挑战:关于一例儿科病例(病例报告)

Diagnostic and therapeutic challenges of a heparin-induced thrombocytopenia in HIV immunodeficiency: in regards to a pediatric case (a case report).

作者信息

Zouine Mouna, Boussadani Yousra El, Oulmaati Abdallah

机构信息

Pediatrics and Neonatology Department, Mohammed VI University Hospital Center of Tangier, Tangier, Morocco.

Faculty of Medicine and Pharmacy, Abdelmalek Essaâdi University, Tangier, Morocco.

出版信息

Pan Afr Med J. 2025 Jun 13;51:43. doi: 10.11604/pamj.2025.51.43.46466. eCollection 2025.

Abstract

We are dealing with a female infant case who had a cerebral venous thrombosis, revealing a secondary immunodeficiency, owing to a human immunodeficiency virus infection. After anticoagulant treatment with low-molecular-weight heparin (LMWH), it came to light that she had a severe thrombocytopenia, suggesting a thrombocytopenia induced by an auto-immune origin of heparin. Within a developing country in which means of confirmation are not always available, it was difficult to identify whether severe thrombocytopenia was owing to HIV infection, sepsis, or heparin. The therapeutic decision was therefore difficult, because stopping anticoagulation can lead to a cerebral thrombosis extension.

摘要

我们正在处理一例患有脑静脉血栓形成的女婴病例,该病例显示由于人类免疫缺陷病毒感染导致继发性免疫缺陷。在用低分子肝素(LMWH)进行抗凝治疗后,发现她患有严重血小板减少症,提示肝素自身免疫源性诱导的血小板减少症。在一个并非总能获得确诊手段的发展中国家,很难确定严重血小板减少症是由HIV感染、败血症还是肝素引起的。因此,治疗决策很困难,因为停止抗凝可能导致脑血栓扩展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e12/12374743/1e07ddda5df5/PAMJ-51-43-g001.jpg

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