Koopman L P, Plötz F B, Meuzelaar J J, Knoester H
Department of Paediatrics, University Hospital Groningen, The Netherlands.
Eur J Pediatr. 1998 Mar;157(3):236-8. doi: 10.1007/s004310050802.
We report a 4-week-old boy with acute respiratory distress, due to massive haemorrhages in multiple thymic cysts. A right hemithymectomy was performed because of mechanical obstruction of the trachea by the cysts. The origin of the multilocular thymic cysts remained unclear. Most likely, these haemorrhages were caused by vitamin K deficiency, although the infant received vitamin K prophylaxis. In addition, he developed transient cholestasis, but the aetiology remained unclear. It is postulated that massive haemorrhages in thymic cysts produce large amounts of bilirubin, causing sludging of bile excretions in the liver. Four weeks after the operation, all laboratory findings were normal and 6 months after the operation the boy is still healthy.
This case report shows that respiratory distress in an infant can be caused by multiple haemorrhages in multilocular thymic cysts.
我们报告了一名4周大的男婴,因多个胸腺囊肿大量出血而出现急性呼吸窘迫。由于囊肿对气管造成机械性梗阻,遂行右半胸腺切除术。多房性胸腺囊肿的起源尚不清楚。尽管该婴儿接受了维生素K预防治疗,但这些出血很可能是由维生素K缺乏引起的。此外,他还出现了短暂性胆汁淤积,但病因仍不清楚。据推测,胸腺囊肿内的大量出血会产生大量胆红素,导致肝脏胆汁排泄淤滞。术后四周,所有实验室检查结果均正常,术后6个月该男婴仍健康。
本病例报告表明,婴儿的呼吸窘迫可能由多房性胸腺囊肿的多处出血引起。