Peyton B D, Cutler B S, Stewart F M
Department of Surgery, University of Massachusetts Medical Center, Worcester 01655, USA.
J Vasc Surg. 1998 Mar;27(3):563-7. doi: 10.1016/s0741-5214(98)70335-0.
Pneumonia is the most common serious complication of varicella infection in adults. A variety of thrombotic complications including purpura fulminans and disseminated intravascular coagulation have been reported in children with varicella but not in adults. Two men with varicella pneumonia who had profound lower extremity ischemia caused by thrombosis of the profunda femoris and tibial arteries are reported. Both patients had free protein S deficiency and vascular thrombosis in association with varicella pneumonia without overt evidence of disseminated intravascular coagulation or purpura fulminans. Antiphospholipid immunoglobulin G and immunoglobulin M antibodies were present in one, whereas the other had evidence of the lupus anticoagulant. The proposed pathogenesis and management options including intraarterial thrombolytic therapy with urokinase and the need for long-term anticoagulation are discussed.
肺炎是成人水痘感染最常见的严重并发症。已有报道称，水痘患儿会出现多种血栓形成并发症，包括暴发性紫癜和弥散性血管内凝血，但成人中未见此类报道。本文报告了两名患水痘肺炎的男性，他们因股深动脉和胫动脉血栓形成而出现严重的下肢缺血。两名患者均存在游离蛋白S缺乏和血管血栓形成，且与水痘肺炎相关，无弥散性血管内凝血或暴发性紫癜的明显证据。其中一名患者存在抗磷脂免疫球蛋白G和免疫球蛋白M抗体，而另一名患者有狼疮抗凝物的证据。文中讨论了推测的发病机制和管理方案，包括使用尿激酶进行动脉内溶栓治疗以及长期抗凝的必要性。
