Claass A, Gaude M, Schröder H
Klinik für Allgemeine Pädiatrie, Universität Kiel.
Dtsch Med Wochenschr. 1993 Jun 18;118(24):898-902. doi: 10.1055/s-2008-1059402.
An eight-week old infant with alcohol embryopathy, weighing 3,700 g, was found to have abnormal liver functions (GPT 312 U/l, Quick value 25%) after surgical repair of a stenosis of the left ureter at its origin. The hospital notes indicated that the infant had been given a total of 1.6 g paracetamol over 60 hours for postoperative restlessness and pain. The serum paracetamol level was 60 mg/l 8 hours after the last dose of the drug. Blood exchange transfusion lowered the paracetamol level to 11 mg/l within 14 hours. After the exchange transfusion further signs of poisoning, namely renal impairment and a severe encephalopathy were noted, and Candida was demonstrated in urine, tracheal secretion and ascites. The renal and hepatic damage proved reversible under symptomatic treatment. But the child, now 1 year old, is severely retarded mentally and in its motor functions. These sequelae may be a residue of the paracetamol poisoning, complications of the clinical course or a combination of the two.
一名8周大、体重3700克的患有酒精胚胎病的婴儿,在接受左输尿管起始部狭窄的手术修复后,肝功能异常(谷丙转氨酶312 U/l,奎克值25%)。医院记录显示,该婴儿在术后因烦躁不安和疼痛在60小时内共服用了1.6克对乙酰氨基酚。最后一剂药物服用8小时后,血清对乙酰氨基酚水平为60毫克/升。换血疗法在14小时内将对乙酰氨基酚水平降至11毫克/升。换血疗法后,出现了进一步的中毒迹象,即肾功能损害和严重脑病,并且在尿液、气管分泌物和腹水中发现了念珠菌。经对症治疗,肾和肝损伤证明是可逆的。但这个现在1岁的孩子在智力和运动功能方面严重发育迟缓。这些后遗症可能是对乙酰氨基酚中毒的残留影响、临床病程的并发症或两者的结合。