新生儿传染性单核细胞增多症1例报告

患儿,男,34天,孕1产1,足月顺产,Ap-gar评分1分钟4分,5分钟6分。出生体重4200g。入院时日龄16天,因全身皮疹5天,发热3天入院。生后第11天起发现颜面部、　臀部散在芝麻大小暗红色皮疹,发热不规则,　最高达39.8℃。入院查体:神志清,反应好,　无浅表淋巴结肿大,全身皮疹呈斑丘疹,疹间　皮肤正常,有互相融合趋势,无脱屑及溃烂,　压之褪色很快复原。心肺查体无异常。肝肋　下3.5cm可及,脾肋下2.5cm可及。实验室　检查:血象白细胞12.5×109/L,最高达32×109/L,其中淋巴细胞计数最高达13.9×109/L,血红蛋白139g/L,最低降至124g/L,血小板180×109/L,最低至73×109/L,肝功能受     

腹膜透析治疗婴儿溶血尿毒综合征五例报告

腹膜透析治疗婴儿溶血尿毒综合征五例报告张桂莲，张姿英，林瑞霞，王宗敏溶血尿毒综合征（ＨＵＳ），是婴幼儿期急性肾功能衰竭的主要病因，腹膜透析为主要治疗手段之一。我们采用腹膜透析治疗５例婴儿ＮＵＳ，报告如下。一般资料：男４例，女１例，均为婴儿；其中３例为...     

传染性单核细胞增多症伴心肌损害59例报告

传染性单核细胞增多症(IM)是儿童常见病毒性传染病,常以发热、咽炎、外周淋巴结及肝脾肿大 等为主要表现,而有关心脏损害的报告较少。我院对1997年7月～1998年1月IM患儿59例进行心肌酶谱及心电图检查,现报告如下。 临床资料 一、对象 选符合以下3项诊断为IM的患儿,共59例:①发热、咽炎、外周淋巴结肿大、肝脾肿     

儿童传染性单核细胞增多症58例报告

传染性单核细胞增多症尚无特异性疗法,为探讨α-干扰素对本病的治疗效果,现将我院近2年诊断明确的58例患儿总结如下。 临床资料 一、诊断标准 (1)具有发热、咽峡炎、淋巴结肿大及肝、脾肿大等;(2)外周血有一次查见异形淋巴细胞占白细胞总数的10％以上;(3)外周血有一     

196例传染性单核细胞增多症的并发症和实验室检查

目的 总结传染性单核细胞增多症(传单)患儿的并发症与实验室检查特点，利剩于减少临床漏诊与误诊。方法 回顾性分析1999年1月～2000年12日我院收治196例传单患儿并发症的发生情况和实验室检查特点。结果 本组83％病例发生于7岁以下儿童，并发症发生率踟％，尤以肝脏损坏最常见。眼睑水肿发生率19．8％，是传单常见的一种临床表现。并发症累及2个或2个以上系统占21％，而发生中枢系统并发症或多器官系统损坏者预后不良。变异淋巴细胞比例增高见于90％以上病例，其是诊断传单简便有效的筛查手段，但其增高程度与疾病的病情和预后无关。EBV—VCA—IgM的阳性率与病程、年龄等因素有关。结论 尽管大多教传单呈良性临床经过，且多具有较典型的临床表现，但本病并发症常见且多样，可累及多种器官、系统，影响疾病的转归和预后。对EBV-VCA-IgM阴性而临床高度怀疑该病病例可采用EBV抗原原位杂交或PCR扩增技术协助诊断。因此，提高时本病鼻废症和实验室检查特点的认识有助于减少临床误诊和漏诊。     

小儿重型传染性单核细胞增多症死亡1例报告

传染性单核细胞增多症(IM)是一种由EB病毒所致的急性或亚急性感染性疾病，近年来儿童发病率逐年增多，且临床表现多样化，并发症多，病情重。我科曾收治1例发热、皮疹待查的患儿，死亡后经尸解证实为“重型传染性单核细胞增多症”，现报道如下。     

A new case of relapsing hemolytic and uremic syndrome

Relapsing hemolytic and uremic syndrome is infrequent in pediatric patients. The case of an infant who had HUS at 11 months of age and subsequently developed two relapses at 3 years and 3 1/2 years of age is reported. Outcome of the first episode was favorable, with no elements suggesting an increased risk for subsequent relapses. Conversely, the second and third episodes were followed by gradual deterioration of renal function and persistence of severe arterial hypertension. To clarify the epidemiology, clinical manifestations, histology, and outcome of HUS, the 24 pediatric cases of relapsing HUS reported in the English-language medical literature were reviewed. In this group, mean age at onset was 4 years 1 month (range 4 months-9 years) and number of relapses ranged from 1 to 14. Evidence of microangiopathy was the most common histologic finding (15/22) but non-specific lesions were seen in some instances. Opinions vary as to the prognosis of relapsing HUS; our case suggests that relapses are of adverse prognostic significance.     

婴儿脊髓空洞症并神经源性膀胱1例报告

1　病例报告　　患儿 ,男 ,1岁 ,因反复发热伴发育迟缓 7个月于 2 0 0 2年 11月 2 8日入院。患儿为第 1胎第 1产 ,母孕早期有先兆流产史 ,足月顺产 ,生后母乳喂养。5个月大时 ,患儿开始出现反复发热 ,体温波动在37.8℃～ 39℃之间 ,少汗或无汗 ,皮肤干燥 ,四肢活动少 ,营养差。     

川崎病合并自身免疫性溶血性贫血和巨噬细胞活化综合征1例

患儿,男,3岁,因发热5 d,皮疹伴颈部淋巴结肿大2 d入院.患儿5 d前出现发热,体温38～41.1℃.2 d前出现皮疹并发现右颈部包块,经多种抗生素治疗5 d无效.杏体:T 39.4℃,躯干部见大片状红色斑丘疹,右颈部扪及多个肿大淋巴结,形成5 cm×5 cm大小包块,质韧,无触痛,表面皮肤无红肿.左颈部扪及多个肿大淋巴结,直径1～2 cm不等.双球结膜充血.     

CFHR家族基因变异致儿童非典型溶血尿毒综合征1例报告并文献复习

目的 分析CFHR家族基因变异导致的儿童非典型溶血尿毒综合征(aHUS)的临床特征.方法 回顾分析1例aHUS患儿的临床资料,以及采用二代测序技术进行的相关基因变异分析结果.结果 女性患儿,8岁,呼吸道感染后出现面色苍黄、肉眼血尿.实验室检查示溶血性贫血、血小板减少、急性肾衰竭、低补体C3血症、补体C4无异常;肾脏病理...     

Recurrent hemolytic uremic syndrome

Hemolytic uremic syndrome (HUS) in children follows a diarrheal prodrome (D+) approximately 90% of the time, and recurrence due to enteric reinfection with Shiga toxin producing E. coli (e.g., O157:H7) can occur but is rare. It is not well recognized that nondiarrheal (D-) recurrences can also follow an episode of D+ HUS; we report 2 unrelated females who experienced multiple D- episodes following an initial episode of D+ HUS. We also present an HUS classification system that includes recurrence risk. It illustrates that recurrence is seen most frequently with familial HUS but can also occur in cases that are secondary to drugs, cancer, and pregnancy.     

Atypical hemolytic uremic syndrome

The pathogenesis of atypical uremic syndrome (HUS), which is rarely encountered in childhood, is poorly understood and its mortality and morbidity rates are high. A wide variety of therapeutic approaches has been attempted and the literature contains numerous conflicting reports about the results of these approaches. In a case diagnosed as recurrent atypical HUS, pulse methyl prednisolone, fresh frozen plasma infusions and plasma exchange transfusion were used at different stages of the disease with satisfactory response.     

Pneumococcal hemolytic uremic syndrome

We report Hemolytic Uremic Syndrome (HUS) induced by Streptococcus pneumoniae in a 20 month-old girl. She responded well to hemodialysis.