Asian Case Reports in Pediatrics
ISSN / EISSN : 2328-045X / 2328-0441
Published by: Hans Publishers (10.12677)
Total articles ≅ 53
Latest articles in this journal
Asian Case Reports in Pediatrics, Volume 09, pp 1-7; https://doi.org/10.12677/acrp.2021.91001
目的：了解不完全性川崎病合并嗜血细胞综合征的发生发展过程，提高对该疾病的认识和警惕。方法：回顾分析1例婴幼儿免疫球蛋白治疗无反应型不完全性川崎病合并嗜血细胞综合征的临床资料。结果：该2岁大男性患儿入院时符合不完全川崎病诊断，两次免疫球蛋白冲击治疗无效，仍反复高热，最后发展为嗜血细胞综合征，出现血常规提示3系下降、肝功能异常、血清铁蛋白升高等，骨髓细胞学检测可见噬血现象等，最后按HLH-04化疗方案治疗好转出院。结论：不完全性川崎病免疫球蛋白治疗无效，应早期激素或免疫抑制剂治疗，并提高对该病的早期识别及干预，早期阻断该病发展为嗜血细胞综合征。 Objective: To understand the occurrence and development of incomplete Kawasaki disease with the hemophagocytic syndrome, and to raise awareness and vigilance of the disease. Method: The clinical data of incomplete Kawasaki disease with the hemophagocytic syndrome in a 2-year-old boy was retrospectively analyzed. Results: We report here a case of a 2-year-old boy with incomplete Kawa-saki disease which resistant to two doses of immunoglobulins and have recurrent hyperthermia. Eventually develop into hemophagocytic syndrome, in which blood tests demonstrated blood rou-tine showed the decline of 3 lines, abnormal liver function, elevated serum ferritin, and hemopha-gocytosis features on bone marrow aspirate. Finally, recovery was obtained with the HLH-04 chem-otherapy regimen. Conclusion: When the immunoglobulin therapy for incomplete Kawasaki disease is ineffective, early glucocorticoid or immunosuppressive therapy should be used. Besides, we should improve the early recognition and intervention of the disease, and block the development of the disease into hemophagocytic syndrome.
Asian Case Reports in Pediatrics, Volume 8, pp 33-39; https://doi.org/10.12677/acrp.2020.84007
目的：探讨分析急性淋巴细胞白血病患儿在诱导缓解化疗过程中并发颅内静脉窦血栓的相关危险因素及后续治疗。方法：回顾性分析南方医院2例急性淋巴细胞白血病患儿在VDLP诱导缓解化疗过程中并发颅内静脉窦血栓形成的临床表现及形成血栓的危险因素及相关治疗，并结合文献进行分析。结果：2例患儿在我院完善骨髓MICM，明确诊断为急性淋巴细胞白血病，予CCCG-ALL-2015方案开始VDLP诱导缓解化疗，诱导过程1例出现抽搐、小便失禁、意识不清，伴有凝血功能异常。1例反复出现头痛伴非喷射性呕吐，两例患儿进行头颅MRI支持颅内静脉窦血栓形成，给予抗凝治疗后病情好转，顺利进行后续巩固治疗。讨论：随着化疗方案不断优化，儿童ALL缓解率已可达90%以上，总体生存率已达80%以上。特别是近年来左旋门冬旋胺酶和培门冬酶的应用，进一步提高了急性淋巴细胞白血病化疗过程中的缓解率及无病生存率，但关注化疗带来益处的同时也应密切关注并发症的发生。其中血栓栓塞性疾病并未得到相应的关注。在小儿恶性肿瘤中，ALL是最易发生血栓的恶性肿瘤，不仅是急性淋巴细胞白血病疾病本身，特别是在VDLP诱导过程中泼尼松联合门冬酰胺酶诱导过程中最易发生。患儿在化疗过程中出现头痛、抽搐、呕吐等应及时完善头颅CT、头颅MRI。可及时发现病情，及早诊断，及时有效治疗可减少相关后遗症的发生。 Objective: To investigate the risk factors and subsequent treatment of intracranial venous sinus thrombosis (CVT) in children with acute lymphoblastic leukemia (ALL) during induction remission chemotherapy. Methods: The clinical manifestations, risk factors and related treatments of intra-cranial venous sinus thrombosis during VDLP induced remission chemotherapy in 2 children with acute lymphoblastic leukemia in Nanfang Hospital were analyzed retrospectively, and the literature was combined for analysis. Results: The bone marrow MICM of 2 children was improved in our hos-pital and was clearly diagnosed as acute lymphoblastic leukemia. VDLP induced remission chemo-therapy was started with THE CCCG-ALL-2015 regimen. During the induction process, 1 child had convulsions, urinary incontinence, confusion, and abnormal coagulation function. One case had re-current headache with non-ejection vomiting, and two cases underwent cranial MRI to support in-tracranial venous sinus thrombosis. After anticoagulant treatment, the condition was improved, and subsequent consolidation treatment was carried out successfully. Discussion: With the contin-uous optimization of chemotherapy regimens, the remission rate of ALL in children has reached more than 90%, and the overall survival rate has reached more than 80%. Especially in recent years, the application of l-aspartase and peraspartase has further improved the remission rate and disease-free survival rate in the course of chemotherapy for acute lymphoblastic leukemia. However, it is necessary to pay close attention to the occurrence of complications while paying attention to the benefits of chemotherapy. Thromboembolic diseases have not received corresponding attention. Among malignant tumors in children, ALL is the most prone to thrombosis, not only in acute lym-phoblastic leukemia itself, but especially in the induction of prednisone combined with asparagi-nase during VDLP. In the course of chemotherapy, headache, convulsion, vomiting and other symp-toms, cranial CT and cranial MRI should be timely perfected. Timely detection of disease, early di-agnosis, timely and effective treatment can reduce the occurrence of related sequelae.
Asian Case Reports in Pediatrics, Volume 8, pp 1-6; https://doi.org/10.12677/acrp.2020.81001
目的：探讨儿童腹膜后畸胎瘤的临床及诊治特点。方法：回顾性分析１例儿童腹膜后畸胎瘤患儿的一般临床资料、辅助检查及治疗过程。结果：对患儿行开腹探查，切除肿瘤，术后病理报告为成熟性囊性畸胎瘤。结论：儿童腹膜后畸胎瘤早期多无明显症状，诊断主要依靠影像学检查，诊断明确后应及时手术治疗。 Objective: To investigate the clinical feature and diagnose treatment experiment of pediatric retroperitoneal teratoma. Methods: We retrospectively analyzed the clinical data, auxiliary examination results and treatment process of a child with retroperitoneal teratoma in our hospital. Results: The postoperative pathology was a mature cystic teratoma after surgical resection. Conclusion: Retroperitoneal teratoma in children always presents no obvious symptoms in the early state, and it could be diagnosed mostly depending on imaging examination. Surgical treatment should be timely after definite diagnosis.
Asian Case Reports in Pediatrics, Volume 8, pp 18-22; https://doi.org/10.12677/acrp.2020.82004
川崎病(Kawasaki disease, KD)是一种以全身性血管炎为特征的急性自限性疾病，病因尚不清楚，静脉注射丙种球蛋白(intravenous immunoglobulin, IVIG)联合阿司匹林治疗可缓解川崎病的炎症反应，但仍有部分患者对治疗无反应，本文主要针对英夫利昔单抗在IVIG无反应型川崎病中的应用进行综述。 Kawasaki disease is an acute self-limited disease characterized by systemic vasculitis; etiology is unclear; intravenous immunoglobulin and aspirin therapy can alleviate the inflammation of Kawasaki disease, but there are still some patients do not respond to treatment. This review focuses on the application of infliximab in IVIG reactive Kawasaki disease.
Asian Case Reports in Pediatrics, Volume 8, pp 7-11; https://doi.org/10.12677/acrp.2020.81002
目的：探讨高IgM综合症病因、临床表现、诊断和治疗。方法：对我科诊断X连锁高IgM综合症患者的临床资料进行回顾及分析。结果：患者因生后反复多次感染住院，多次血常规示中性粒细胞计数降低，多次免疫球蛋白检查示无IgA和IgG降低，且IgM正常，基因检测示CD40L基因突变，诊断为X连锁高IgM综合症。结论：在临床工作中，易出现反复感染伴中性粒细胞计数减少的患儿，需警惕免疫缺陷病。 Objective: To investigate the causes, clinical manifestation, diagnosis and treatment of Hyper-IgM syndrome. Methods: The clinical data of one child with X-linked hyper-IgM syndrome diagnosed by our department were analyzed retrospectively. Results: The child was admitted to hospital due to repeated infection after birth. Repeated blood tests showed decreased neutrophils count, repeated immunoglobulin tests showed no IgA or IgG decrease, and IgM was normal. Gene tests showed CD40L gene mutation, which was diagnosed as X-linked hyper-IgM syndrome. Conclusion: In clinical practice, children prone to recurrent infection with decreased neutrophils count need to alert to immunodeficiency disease.
Asian Case Reports in Pediatrics, Volume 8, pp 13-17; https://doi.org/10.12677/acrp.2020.82003
目的：提高对儿童急性淋巴细胞白血病合并可逆性后部脑病综合征的认识。方法：回顾分析南方医院收治的2名急性淋巴细胞白血病合并可逆性后部脑病综合征的临床资料，并结合文献进行分析。结果：2名患儿在急性淋巴细胞白血病治疗过程中出现意识障碍、高血压、抽搐等症状。头颅MRI显示双侧顶、枕、颞叶皮层或皮层下长T2信号。经过降压等对症处理后症状缓解。结论：PRES发病机制是多方面的，早期诊断、早期治疗可使病情在短期内逆转。 Objective: To improve recognition of acute lymphoblastic leukemia with posterior reversible en-cephalopathy syndrome in children. Method: Two ALL children with PRES admitted to Nanfang Hospital were included. Clinical data were retrospectively studied and related literatures were re-viewed. Result: During the treatment of acute lymphoblastic leukemia, 2 children developed symptoms of consciousness disorder, hypertension and convulsion. Cranial MRI showed bilateral parietal, temporal and occipital cortical or subcortical lesions with hypointensity on T2-weighted imaging. Clinical symptoms were resolved soon after supportive care such as anti-hypertension. Conclusion: The pathogenesis of PRES is multifaceted. Early diagnosis and treatment are very im-portant.
Asian Case Reports in Pediatrics, Volume 8, pp 28-31; https://doi.org/10.12677/acrp.2020.83006
目的：探讨婴幼儿湿疹合并卡波西水痘样疹临床及诊治特点。方法：回顾性分析苏州科技城医院收治的1例婴幼儿卡波西水痘样疹的临床资料，并结合文献进行分析。结果：婴幼儿湿疹治疗及护理不当可继发卡波西水痘样疹。结论：卡波西水痘样疹患儿早期使用阿昔洛韦联合丙种球蛋白治疗可以减轻病毒对机体的损害，缩短病程，促进皮疹愈合及脱落。 Objective: To investigate the features of clinical, diagnosis and treatment in infants eczema with kaposi’s varicella eruption. Method: An infant with Kaposi’s varicella eruption admitted to Suzhou Science and Technology Town Hospital is included. Clinical data were retrospectively studied and related literatures were analyzed. Result: Improper treatment and care of infants with eczema will lead to Kaposi varicelliform eruption. Conclusion: Early treatment with acyclovir combined with gamma globulin in infants with kaposi varicelliform eruption can reduce the damage of the virus, shorten the course of the disease, and promote the healing and shedding of the rash.
Asian Case Reports in Pediatrics, Volume 8, pp 23-27; https://doi.org/10.12677/acrp.2020.83005
目的：探讨猫抓病的临床特征及诊断方法。方法：回顾性分析7例猫抓病患者的流行病学资料、临床表现、辅助检查结果和诊断等。结果：7例患者中，2例患者有明确长期与猫、狗密切接触史。7例患者均表现为淋巴结肿大或局部肿块，质地中等或硬；7例患者CRP均升高，6例患者血沉加快；7例患者入院疑诊淋巴瘤或淋巴结核或转移癌2例，淋巴瘤1例，淋巴结炎1例，颌下腺混合瘤1例，腋下肿物查因2例，所有患者淋巴结活检均提示：淋巴结肉芽肿性炎。结论：猫抓病临床表现多样，一般全身症状多轻微，最常见的临床表现是淋巴结肿大，多有触痛，多表现为CRP升高，血沉增快，易漏诊误诊，该病抗生素治疗有效。 Objective: To explore the clinical characteristics and diagnosis of cat scratch disease. Methods: The epidemiological data, clinical manifestations, auxiliary examination results and diagnosis of 7 cases of cat scratch disease were analyzed retrospectively. Results: Of the 7 patients, 2 had a long history of close contact with cats and dogs. All the patients presented with lymphadenopathy or local mass with medium or hard texture; 7 patients had elevated CRP and 6 patients had accelerated ESR; 7 patients had suspected lymphoma or lymphadenitis or metastatic cancer in 2 cases, lymphoma in 1 case, lymphadenitis in 1 case, mixed tumor in submandibular gland in 1 case, and axillary mass in 2 cases. All the patients had lymphadenitis granulomatous. Conclusion: The clinical manifestations of cat scratch disease are various, and the general systemic symptoms are mostly mild. The most common clinical manifestations are lymphadenopathy, tenderness, high CRP, rapid ESR, easy misdiagnosis and missed diagnosis.
Asian Case Reports in Pediatrics, Volume 7, pp 35-41; https://doi.org/10.12677/acrp.2019.74006
目的：探讨NICU收治的维、汉族新生儿听力筛查未通过的影响因素，为听力障碍早期干预策略提供依据。方法：新疆自治区妇幼保健院NICU2017年1月~2017年12月收治维族、汉族各524、1533例高危儿作为研究对象。采用TEOAE在生后72小时进行听力初筛，对病例进行疾病构成比、听力未通过疾病构成比分析，通过χ2检验，比较维、汉族新生儿听力筛查未通过的影响因素。结果：新生儿听力筛查未通过率，维、汉族为25.19%、12.26%。以早产或极低体重、宫内感染、高胆红素血症、窒息、肺炎、妊娠糖尿病、胎粪吸入综合征、溶血病、湿肺为序，维、汉族疾病构成比(%)为42.37、10.11、19.27、8.78、4.96、7.25、2.48、1.91、2.86；27.40、8.35、39.86、4.24、3.98、10.37、2.41、1.76、1.63，两者构成有差异(P Objective: To analyze the results of Uygur and Han newborn hearing screening in neonatal intensive care unit (NICU) and to investigate the effective factors affecting hearing screening. Methods: Both 524 Uyghur and 1533 Han newborns in NICU received hearing screening test by transient evoked otoacoustic emission (TEOAE) and the effective factors were investigated. Chi-square test was used to analyze the differences of unpassed rate and the effective-factors, respectively. Results: The constituent ratio of premature, intrauterine infection, hyperbilirubinemia, asphyxia, pneumonia, gestational diabetes, meconium aspiration syndrome, neonatal hemolytic disease and wet lung in NICU Uygur newborns was as 42.37, 10.11, 19.27, 8.78, 4.96, 7.25, 2.48, 1.91 and 2.86 respectively, and the corresponding disease constituent ratio of Han newborns was 27.40, 8.35, 39.86, 4.24, 3.98, 10.37, 2.41, 1.76 and 1.63 and there was statistically significance (P
Asian Case Reports in Pediatrics, Volume 7, pp 1-6; https://doi.org/10.12677/acrp.2019.71001
目的：提高对先天性中枢性低通气综合征(CCHS)临床表现、诊断及治疗的认识。方法：分析总结1例于我院住院治疗的伴有肺动脉高压的CCHS患儿的临床资料，并进行文献复习。结果：患儿初次入院以肺动脉高压为首发症状，入院时面罩吸氧下氧饱和度难以维持正常，遂予机械通气，病情平稳后撤机出院，但患儿短时间内多次因呼吸道感染、低氧血症入院治疗，期间存在呼吸机撤机困难及夜间自主呼吸差等症状，除外肺部原发病以及神经肌肉功能障碍等疾病后，完善全外显子基因检测，PHOX2B基因存在变异，结合患儿临床表现及基因检测结果诊断为先天性中枢性低通气综合征，经无创正压通气及支持治疗后，患儿肺动脉压力下降明显，氧和可维持基本稳定，生活质量明显改善。结论：CCHS患儿经无创双水平正压通气治疗后可显著改善预后。 Objective: To describe the clinical characteristics of congenital central hypoventilation syndrome (CCHS) with pulmonary hypertension. Methods: We retrospectively analyzed a patient with CCHS who presented with pulmonary hypertension and review of the literature. Results: The patient presented with pulmonary hypertension at the time of first hospitalization, and echocardiogram revealed enlarged right ventricle and atrium, in spite of activity measures including mechanical ventilation and supportive treatment, the patient had persistent cyanosis and dyspnea, the patient proceeded with genetic testing. A genetic research was performed by polymerase chain reaction for CCHS screening, which showed the mutated allele of PHOX2B gene, confirming the diagnosis. After non-invasive positive pressure ventilation treatment, the patient thrived with normal growth and development. Conclusion: The present paper illustrates that the most effective and common method of treatment for CCHS is non-invasive bi-level positive pressure ventilation.