Clinical feature analysis of 24 children with thrombotic microangiopathy
10.3760/cma.j.issn.1673-4904.2015.11.012
- VernacularTitle:小儿血栓性微血管病24例临床特征分析
- Author:
Xiaoying WANG
;
Hong GUO
;
Xinhui LUO
- Publication Type:Journal Article
- Keywords:
Thrombotic microangiopathies;
Hemolytic-uremic syndrome;
Thrombocytopenic purpura;
Child
- From:
Chinese Journal of Postgraduates of Medicine
2015;(11):820-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical feature and therapeutic strategy for children with thrombotic microangiopathy (TMA). Methods The clinical manifestation, auxiliary examination and treatment of 24 cases of children with TMA was analyzed retrospectively. Hemolysis urine toxin syndrome (HUS)occurred in 22 cases, and thrombotic thrombocytopenic purpura (TTP) occurred 2 cases. Results Sixteen cases was onset from May to July,and 8 cases was onset from September to November. Typical HUS (D+HUS) was 8 cases, and atypical HUS (D-HUS) was 14 cases. In 22 HUS children, 18 cases were given hemodialysis or peritoneal dialysis treatment. The illness were significantly improved, and the platelet count and renal function fully recovered normal. But 1 case appeared neurological symptoms such as headache, facial paralysis on one side, gastrointestinal bleeding, and fever, after getting better. Eventually the patient died of disseminated intravascular coagulation. Two cases of TTP were given plasma exchange , anti-infection, large dose of methylprednisolone and anti- platelet aggregation treatment . After treatment, the level of hemoglobin and blood platelets returned normal and consciousness was recuperated. Conclusions HUS and TTP are similar in pathogenesis and clinical manifestation,and it is necessary to be differentiated. Early diagnosis and proper treatment is the key to save the life of children with TMA. As soon as the diagnosis is clear, hemodialysis or peritoneal dialysis treatment should be given to HUS, and plasma exchange to TTP,to quickly control the condition and improve the clinical symptoms.
