Riccabona M, Kerbl R, Schwinger W, Spork D, Millner M, Grubbauer H M
Univ. Kinderklinik Graz.
Klin Padiatr. 1993 Nov-Dec;205(6):421-3. doi: 10.1055/s-2007-1025261.
43 children suffering from borreliosis, meningitis and septicemia were treated with ceftriaxone. A six year old boy with acute jaundice due to ceftriaxone induced cholelithiasis encouraged us to reevaluate the frequency of ceftriaxone induced cholelithiasis and its' sequelae in children in a prospective study. Out of 43 children (age 6.3 years, 4 months to 16 years, male: female 25:18), 20 children (46.5%) showed sonographical evidence for ceftriaxone induced cholelithiasis after a treatment of at least 10 days. Two of them even had signs of intrahepatic cholestasis, 3 kids suffered from severe abdominal pain, non of them showed serologic abnormalities. Another 5 children (11.6%) had sludge in the gallbladder without evidence for cholelithiasis. In all patients the "pseudocholelithiasis" spontaneously resolved within at most 2 months. We suggest a sonographical examination of the gallbladder at the end of the ceftriaxone treatment in order to detect cholelithiasis, which might call for further monitoring and maybe dietary treatment.
43名患有莱姆病、脑膜炎和败血症的儿童接受了头孢曲松治疗。一名因头孢曲松诱发胆石症而出现急性黄疸的6岁男孩促使我们在前瞻性研究中重新评估儿童中头孢曲松诱发胆石症及其后遗症的发生率。在43名儿童(年龄6.3岁,4个月至16岁,男:女为25:18)中,20名儿童(46.5%)在至少治疗10天后超声检查显示有头孢曲松诱发胆石症的证据。其中2名儿童甚至有肝内胆汁淤积的迹象,3名儿童患有严重腹痛,他们均未出现血清学异常。另外5名儿童(11.6%)胆囊有胆泥但无胆石症证据。在所有患者中,“假性胆石症”最多在2个月内自行消退。我们建议在头孢曲松治疗结束时对胆囊进行超声检查,以检测胆石症,这可能需要进一步监测,也许还需要饮食治疗。