川崎病合并溶血性贫血1例报告并文献复习

Kawasaki Disease Complicated with Hemolytic Anemia: A Case Report and Literature Review

目的:探讨川崎病的少见并发症溶血性贫血的发病机制、临床特征以及治疗后效果,提高对该病的认识,做到早期识别及治疗。方法:应用回顾性分析的方法,报道1例川崎病合并溶血性贫血患儿的临床表现、体格检查、实验室检查及治疗反应并结合相关文献进行分析。结果:7月男性患儿,主要表现为发热、皮疹、眼结合膜充血、口唇干裂及手足硬肿,心脏超声示双侧冠状动脉扩张,应用丙种球蛋白治疗出现血红蛋白降低、网织红细胞计数升高,直接抗人球蛋白阳性,应用激素治疗后血红蛋白升至正常水平。结论:溶血性贫血是川崎病应用丙种球蛋白治疗后的少见的并发症,接受高剂量的患者出现溶血的风险更大,临床认识不足,早期识别和积极治疗不良反应具有重要意义。

Objective: To investigate the pathogenesis, clinical characteristics and treatment effect of hemolytic anemia, a rare complication of Kawasaki disease, so as to improve the understanding of this disease and achieve early recognition and treatment. Methods: Retrospective analysis was performed to report the clinical manifestations, physical examination, laboratory examination and treatment response of a child with Kawasaki disease complicated with hemolytic anemia. Results: July male children, mainly characterized by fever, rash, eye combined with membrane hyperemia, lip weather-shack, and brothers hard swollen, echocardiogram in bilateral coronary artery expansion, application of gamma globulin treatment appear lower hemoglobin, reticulocyte count, anti globulin positive people directly, hemoglobin rose to normal level after application of hormone treatment. Conclusion: Hemolytic anemia is a rare complication of Kawasaki disease after the application of gamma globulin therapy. Patients receiving high dose of hemolysis are at greater risk of hemolysis, and clinical understanding is insufficient. Early identification and active treatment of adverse reactions are of great significance.