
儿童噬血细胞综合征合并重症中枢神经系统病变1例救治经验
Treatment experience of hemophagocytic lymphohistiocytosis with severe central nervous system involvement in a child
患儿,男,13岁,因反复发热11 d入院。患儿于11 d前无明显诱因出现发热,弛张高热,热峰40℃,每日2~3次,伴畏寒、寒颤,咽痛,轻咳,服退热药物体温降至正常2~3 h后又反复。到当地医院住院治疗,血常规检查示白细胞计数(WBC)26×109/L,中性粒细胞百分比(N%)87.9%,淋巴细胞百分比(L%)8.7%,血红蛋白(Hb)132 g/L,血小板(PLT)205×109/L;C反应蛋白(CRP)111.46 mg/L,降钙素原(PCT)1.29 ng/mL,肺炎支原体抗体1:160。予头孢哌酮舒巴坦、阿奇霉素、奥司他韦等抗感染治疗,复查血常规示:WBC 10×109/L,N% 83.24%,L% 8.7%,Hb 124 g/L,PLT 241×109/L;CRP 39.25 mg/L,PCT 3.03 ng/mL。发热无好转,来我院急诊,予头孢曲松静脉滴注10 min后出现颜面部多发红色皮疹伴瘙痒,停止头孢曲松输注并口服西替利嗪后皮疹消退,以"发热查因"收住院。
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