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  • Exanthem  (1)
  • Key words Disseminated intra-vascular coagulation  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Are there specific haemostatic abnormalities in children surviving septic shock with purpura and having skin necrosis or limb ischaemia that need skin grafts or limb amputations? (1999)
    Springer
    European journal of pediatrics 158 (1999), S. 127-132 
    Details
    ISSN: 1432-1076
    Schlagwort(e): Key words Disseminated intra-vascular coagulation ; Limb ischaemia ; Purpura fulminans ; Septic shock ; Skin necrosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract More than 10% of children surviving septic shock with purpura have skin necrosis or limb ischaemia (SNLI.). Among 44 children consecutively admitted to our pediatric intensive care unit, 35 (80%) survived, 6 of them (17%) developed SNLI (defined as the need of a surgical procedure). Two timed haemostasis measurements included the determination of coagulation factors, protein C (PC), protein S (PS), C4b binding protein (C4bBP), antithrombin (AT), and plasminogen activator inhibitor 1 (PAI-1). Two severity scores and CRP levels were determined at admission. Children with SNLI and without SNLI were compared. On admission, severity scores, and AT, PC, PS, C4bBP levels were similar in both groups with and without SNLI. Prothrombin time (23% vs 34%; P 〈 0.01), factor VII+X (20% vs 31%; P = 0.05) and factor VII (0% vs 19%; P 〈 0.01) were lower in the group with SNLI. The 2nd sample showed no difference between the two groups. Kinetics of haemostatic abnormalities were no different between the two groups. Conclusion In this series, the only difference between the two groups was lower factor VII levels in children with skin necrosis or limb ischaemia. This suggests the benefit of tissue factor pathway inhibitor administration as an adjunctive therapy to prevent skin necrosis or limb ischaemia. Further studies including more children are needed to determine the potential effects of treatments such as protein C, antithrombin, and plasminogen activator inhibitor antibody administration, and to advocate tissue factor pathway inhibitor in preventing skin necrosis or limb ischaemia.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004310051032
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Hypersensitivitätssyndrom durch Antikonvulsiva (1997)
    Springer
    Monatsschrift Kinderheilkunde 145 (1997), S. 109-113 
    Details
    ISSN: 1433-0474
    Schlagwort(e): Schlüsselwörter Carbamazepin ; Hypersensitivitätssyndrom ; Fieber ; Exanthem ; Lymphadenopathie ; Key words Carbamazepine ; Hypersensitivity syndrome ; Fever ; Skin rash ; Lymphadenopathy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary 2 weeks after initiation of carbamazepine therapy a 3 year old boy presented with skin rash, fever, lymphadenopathy, hepatosplenomegaly and nephritis. After exclusion of infectious diseases our differential diagnosis focussed on carbamazepine induced hypersensitivity syndrome. We found a positive lymphocyte transformation assay and patch test to carbamazepine, indicating a specific response, but no anti-carbamazepine antibody, no circulating immune complexes and no decrease in complement components. The hypersensitivity syndrome refers to a severe hypersensitivity response due to a idiosyncratic reaction. The origin is unknown. The similarity to other multisystem disorders is discussed. Discussion: Not only aromatic antiepileptic agents (carbamazepine, phenobarbital, phenytoin) sulfonamides but as well allopurinol and gold salts are associated with the syndrome. Withdrawal of the drug and treatment with corticosteroids usually lead to complete recovery.
    Notizen: Zusammenfassung Wir berichten über einen 3 jährigen Jungen, der 2 Wochen nach Beginn einer antiepileptischen Behandlung an einem Carbamazepin-induzierten Hypersensitivitätssyndrom, bestehend aus therapieresistentem Fieber, polymorphem Exanthem, oropharyngealen Läsionen, generalisierter Lymphadenopathie, Hepatosplenomegalie und Nephritis, erkrankte. Wir fanden positive Lymphozytenstimulations- und Epikutantests auf Carbamazepin als Ausdruck einer spezifischen Überempfindlichkeit. Spezifische Anti-Carbamazepin-Antikörper, zirkulierende Immunkomplexe oder eine Komplementerniedrigung waren nicht nachweisbar. Es handelt sich um eine Überempfindlichkeitsreaktion unbekannter Ätiologie im Sinn einer Idiosynkrasie. Nach Ausschluß infektiöser Ursachen wird die Differentialdiagnose zu anderen Systemerkrankungen erörtert. Diskussion: Neben aromatischen Antikonvulsiva (Carbamazepin, Phenobarbital, Phenytoin) sind Sulfonamide und Goldsalze mögliche Auslöser eines Hypersensitivitätssyndroms. Absetzen des Induktors und systemische Kortikosteroide führen in der Regel zur vollständigen Remission.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001120050110
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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    Artikel (Nationallizenzen)
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