1例疫苗引起免疫性血小板减少症的报告

A case report of immune thrombocytopenia caused by vaccine

目的为接种疫苗引起的免疫性血小板减少症提供相关的参考资料,便于类似疑似预防接种异常反应调查诊断。方法结合患儿基本情况、临床表现,实验室检查、诊疗及预防接种实施等情况,进行调查诊断。结果该患儿接种第二剂乙肝疫苗3d后全身出现针尖大小出血点,PLT2×10^9/L,HGB93g/L,蛛网膜下腔出血,病毒检测:CMV-DNA(-),EBV-DNA(-),cooms实验(-),血液和免疫系统遗传性疾病的基因筛查未见异常,未发现特异性脂肪酸代谢异常,对症治疗11d后,各项指标较前好转,出院诊断:免疫性血小板减少症、颅内出血、中度贫血。结论该儿童所患免疫性血小板减少症不能排除与接种乙肝疫苗之间的因果关联。

Objective To provide reference materials for immunological thrombocytopenia induced by vaccination,and facilitate the investigation and diagnosis of similar adverse events following immunization.Methods Investigation and diagnosis were carried out according to the basic condition,clinical manifestations,laboratory examination,diagnosis and treatment,and vaccination implementation.Results Three days after the second dose of hepatitis B vaccine in children with systemic appear pinpoint petechiae,PLT 2×109/L,HGB 93 g/L,subarachnoid hemorrhage,virus detection:CMV-DNA(-),EBV-DNA(-),cooms experiment(-),blood and immune system of genetic disease gene screening did not find abnormalities or specificity of fatty acid metabolism.After symptomatic treatment for 11 days,the indicators were better.Discharge diagnosis:immune thrombocytopenia,intracranial hemorrhage,moderate anemia.Conclusion A causal association between immunological thrombocytopenia in this child and hepatitis bvaccination could not be excluded.