Le Luyer B, Bastard C, Devaux A M, Ensel P
Pediatrie. 1983 Jan-Feb;38(1):47-56.
A 81 day old male infant developed an acute hepatitic failure and died shortly thereafter. Determinations of HBs antigen and antibody (AB) and HBeAg and AB were performed in the parents and sibling of the infected child. The mother and a sister were an asymptomatic carrier of HBsAg, the first HBeAg positive and the second HBeAB positive. An elder sibling was HBsAg and HBeAg positive in this serum. The father was anti-HBs positive. In the family of the sister, the man and two childs were HBsAg and anti-HBsAB negative. A new baby in the family of the propositus born and a combination of HB vaccine and HBIg (hepatite B immuno-globulin) was started at birth. Unfortunately the child died of S.D.I.S. (Sudden Death Infant Syndrome). The HB vaccine was immuno-genetic in this infant and the anti-HBs in the immuno-globulin M (IgM) was positive as in several adults controls. This case allow us to discuss vertical transmission of hepatitis B, the clinical aspect of neonatal hepatitis and the preventing HB infection by combinaison of HB vaccine and HBIg.
一名81天大的男婴出现急性肝衰竭,随后不久死亡。对受感染儿童的父母和兄弟姐妹进行了乙肝表面抗原和抗体(AB)以及乙肝e抗原和抗体的检测。母亲和一个姐妹是乙肝表面抗原的无症状携带者,前者乙肝e抗原阳性,后者乙肝e抗体阳性。一个年长的兄弟姐妹血清中乙肝表面抗原和乙肝e抗原呈阳性。父亲乙肝表面抗体呈阳性。在姐妹的家庭中,丈夫和两个孩子乙肝表面抗原和乙肝表面抗体均为阴性。先证者家庭中的一名新生儿出生后,在出生时开始联合使用乙肝疫苗和乙肝免疫球蛋白(HBIg)。不幸的是,该儿童死于婴儿猝死综合征(S.D.I.S.)。乙肝疫苗在这名婴儿中具有免疫原性,免疫球蛋白M(IgM)中的乙肝表面抗体呈阳性,与几名成人对照情况相同。该病例让我们能够讨论乙肝的垂直传播、新生儿肝炎的临床情况以及通过联合使用乙肝疫苗和乙肝免疫球蛋白预防乙肝感染的问题。