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儿科免疫受损患者的关键性肠道穿孔:基于病例的审查
William Hunt Stafford1,2, Jennifer McArthur2, Saad Ghafoor2
1Division of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN 38103, USA.
Pediatric reports
|February 20, 2026
概括
强大的免疫调节疗法可以掩盖儿童的肠道穿孔症状. 微妙的迹象,如胃肠道出血或食不耐受可能表明穿孔,需要早期成像和多学科审查及时干预.
科学领域:
- 儿科瘤学 儿科瘤学
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 改善儿童癌症和免疫疾病的存活率需要管理治疗并发症.
- 肠道穿孔是一种危及生命的并发症,通常表现为腹膜炎和炎症.
研究的目的:
- 报告患有严重肠道穿孔的儿童患者,缺乏典型的临床症状.
- 要突出免疫调节疗法对穿孔呈现的掩盖效应.
主要方法:
- 三名高风险儿科患者的病例报告.
- 对临床表现,治疗和结果的审查.
- 分析免疫调节剂患者的诊断挑战.
主要成果:
- 三名接受高剂量皮质类固醇和/或生物药物的儿科患者出现了严重的肠道穿孔.
- 尽管有穿孔的外科证据,但没有经典症状 (发烧,白细胞瘤,腹痛).
- 所有患者都幸存下来,这是由于微妙的发现引起的早期干预.
结论:
- 免疫调节疗法可以抑制肠道穿孔的典型炎症反应.
- 仅依赖传统的临床症状可能会延迟这些患者的诊断.
- 微妙的迹象 (胃肠道出血,食不耐受) 和早期成像对于及时诊断和改善结果至关重要.
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