治疗性血交换在登革热相关微血管病的作用
Aarushi Sahni1, Sarthak Wadhera2, Divjot Singh Lamba1
1Department of Transfusion Medicine, PGIMER, Chandigarh, India.
Asian journal of transfusion science
|August 21, 2025
概括
在登革热感染中,血栓小血管病变 (TMA) 是罕见的. 早期诊断和及时的治疗性血交换 (TPE) 显著改善了患者的结局,包括溶血参数和损伤.
科学领域:
- 血液学
- 传染性疾病
- 肝脏病学
背景情况:
- 血栓式微血管病 (TMAs) 的特征是微血管性血液溶解性贫血症,血栓塞缩症和缺血性组织损伤.
- 登革热病毒感染很少会导致TMA,通常会出现像登革热脑炎这样的神经复杂症.
- 与登革热相关的TMA的罕见性需要病例报告以了解其临床表现和管理.
研究的目的:
- 报告一种与登革热脑炎并发的二次性TMA病例.
- 强调早期诊断和干预在管理登革热相关的TMA的重要性.
- 突出治疗性血交换 (TPE) 在改善临床结果方面的有效性.
主要方法:
- 确诊了一例涉嫌TMA和脑炎的登革热感染病例.
- 诊断工作包括血液溶解参数和血小板减少的评估.
- 根据使用Spectra Optia细胞分离器的高PLASMIC得分,早期启动治疗性血交换 (TPE).
主要成果:
- 患者出现了与TMA和登革热脑炎相一致的症状.
- 在TPE启动后,血液溶解参数和血小板减少有所改善.
- 与TMA相关的急性损伤也在TPE后得到改善.
结论:
- 登革热病毒感染可以导致TMA,即使存在脑炎.
- 早期启动治疗性血交换 (TPE) 对于管理登革热相关的TMA至关重要.
- 迅速的TPE可以导致血解指标和功能显著恢复.
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