伊曲康唑注射液致多形红斑皮疹1例

<正>患儿男,4岁,因患急性淋巴细胞白血病1年11个月入院。复查骨髓提示复发,予ALL-REZ BFM2002 F2方案[地塞米松20 mg/(m2.d)连用5 d,长春新碱1.5 mg/(m2.d)用1 d,阿糖胞苷3 g/(m2.次)每12小时1次连用2 d,左旋门冬酰胺酶10 000 U/m2用1 d]化疗。入院后40余天,患儿颜     

儿童重症多形红斑6例

我院儿科1990～1998年收治重症多形红班6例,报告如下。临床资料一、一般资料：男5例．女互例,婴儿1例,学龄儿童5例。3例癫病患儿中,2例服苯妥英钠,1例服苯巴比妥．分别在服药12d、15d及30d发病;另3例病前分别患风疹、水痘及用青霉素史。二、临床表现及实验室检查：均以高热伴皮疹起病,发热39C～40C,平均热程16d、4例高热3～7d后出皮疹,2例发热皮疹同起。皮疹遍及全身,颜面、四肢重,皮肤呈水肿性,紫红色．上有斑丘疹,逐日加重,继之大小不等水疮,可融合成片,按压疼痛．尼氏征阴性（按压水瘤不漫延,不易破裂）,痛痒．恢复期…     

卡马西平致大疱表皮松解萎缩坏死型药疹1例

卡马西平致药疹国内曾有报道[1].1997年10月我科收治1例服用该药致严重药疹患儿,现报告如下:     

母亲Rh缺失型-D-致重度新生儿溶血病抢救成功一例

Rh缺失型-D-是一种罕见的Rh血型,经妊娠或输血产生的抗体可导致程度不一的新生儿溶血病.重者发病迅速,病情危重,核黄疸发生率及死亡率极高.Denomme等[1]首次对该病胎儿采用ABO不相合的母亲血进行宫内输血,获得了成功.最近,我们对一例母亲Rh缺失型-D-致严重新生儿溶血病的患儿,采用血清学上最小不相容的血液为其换血治疗,取得了较满意的效果,报告如下.     

血液净化疗法抢救新生儿重度窒息致多脏器功能衰竭一例

患儿,男,G4P1,胎龄37”周,因“宫内窘迫、胎盘早剥”剖宫产娩出,羊水血性,胎盘情况不详,脐带无绕颈,Apgar评分1—1—2,出生体重2500g,身长47cm,头围32cm。因“生后无呼吸半小时”住当地医院治疗,逐渐出现呼吸困难、全身水肿、贫血伴血小板减少、少尿,考虑发生以呼吸衰竭、急性肾功能衰竭为主要表现的多脏器功能衰竭,虽经机械通气与腹膜透析治疗,病情仍呈进行性加重,于生后第7天转入我院新生儿科治疗。     

Precipitants in 42 cases of erythema multiforme

A total of 42 children with erythema multiforme (aged 0.1 to 15.8 years, median 6.1 years) were treated between 1978 and 1997 at the Department of Paediatrics, University of Bern, Switzerland. Antecedent infections were noted in 30 cases: Mycoplasma pneumoniae infection (n = 14), acute upper respiratory tract disease (n = 10) and herpes simplex infection (n = 6). Four cases were associated with antecedent medication (n = 3) or immunization (n = 1). In 12 of the 30 patients in whom erythema multiforme followed an infectious disease, drugs described in the literature as inducers of erythema multiforme had been given for symptoms not suggestive of the condition. In the remaining eight children no precipitating agent could be detected. Conclusion In this survey infections were found as a definite or at least presumptive trigger of erythema multiforme in 71% of cases. Drugs (including immunization) implicated as triggers of erythema multiforme played a definite causative role in 10% and a presumptive role in a further 29% of patients. In 19% of patients an associated condition was not diagnosed. Received: 1 September 1998 / Accepted in revised form: 16 April 1999     

Herpes simplex virus in childhood erythema multiforme.

Although an association between herpes simplex virus (HSV) infection and erythema multiforme (EM) minor has been documented in adults, this has not been reported in the pediatric population. This study assessed the potential role of HSV infection in the pathogenesis of EM minor in children. Erythema multiforme skin lesions from 20 children, aged 1 to 16 years, were examined for the presence of HSV by using the polymerase chain reaction. The children included all fit strict clinical criteria for EM minor. Ten had a clinical history of an antecedent herpes infection ("herpes-associated EM"), and 10 did not ("idiopathic EM"). Herpes simplex virus DNA was detected in skin lesions of 8 of 10 children with herpes-associated EM and in 8 of 10 with idiopathic EM. Control skin biopsies from children with other bullous inflammatory diseases were negative. In addition, no HSV could be detected in a biopsy of normal uninvolved skin of a child in whom HSV was present in lesional skin. In situ hybridization on selected biopsies by means of an HSV-specific riboprobe confirmed the presence of HSV and localized it to the epidermis. It is concluded that HSV is a significant precipitating factor for EM minor in children, as it is in adults, and that clinicians should maintain a high index of suspicion of HSV even in the absence of a known history of herpes infection.     

甘露醇致幼儿严重皮疹1例

患儿 ,男 ,2岁 ,因高热 2d ,嗜睡 1d、抽搐 3次入院。入院前 3h出现四肢抽搐、两眼凝视、口吐白沫、神志不清、持续 4～ 5min停止 ,呈间断发作 3次 ,呕吐胃内容物 1次 ,非喷射状 ,无腹泻。既往无药物、食物过敏史。查体 :T 39℃ ,P 14 2次 /min ,R35次 /min ,体重 11kg。发育正常 ,营养中等 ,嗜睡状。皮肤粘膜无黄染、皮疹及出血点 ,球结膜无水肿 ,双侧瞳孔等大正圆 ,对光反射正常 ,颈抗 ( ) ,双肺无异常 ,心律齐、心脏各瓣膜区无杂音。腰椎穿刺脑脊液滴速 5 6滴 /min ,无色透明 ,潘氏试验 ( ) ,镜检WBC 4 6× 10 6 /L ,N 0 .85 ,L 0 .1…     

Corticosteroid treatment of erythema multiforme major (Stevens-Johnson syndrome) in children

 The effectiveness of systemic corticosteroids in erythema multiforme major (EMM) is controversial. We therefore evaluated the efficacy of corticosteroids in the treatment of EMM in a prospective study of 16 children with EMM admitted to our department within 3 days from the onset of rash. Ten patients (group A) received bolus infusions of methylprednisolone (4 mg/kg/day) while six had only supportive treatment (group B). The early use of corticosteroids compared to supportive treatment resulted in: (1) significant reduction of the period of fever (4.0 ± 1.9 vs 9.5 ± 4.2 days P = 0.01); (2) reduction of the period of acute eruption (7.0 ± 3.3 versus 9.8 ± 3.0 days P = 0.08); and (3) milder signs of prostration. Complications were minimal in both groups. Conclusion The early and short course of corticosteroids favourably influences the course of erythema multiforme major in children. Received: 29 March 1996 / Accepted: 30 July 1996