Fatal thrombotic microangiopathy in an infant with COVID-19: a case report.

IF 0.8 4区医学 Q4 PEDIATRICS

Turkish Journal of Pediatrics Pub Date : 2023-01-01 DOI:10.24953/turkjped.2022.1150

Özlem Sarıtaş Nakip, Selman Kesici, Kıvanç Terzi, Diclehan Orhan, Benan Bayrakcı

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引用次数: 0

Abstract

Background: While macrovascular thrombosis is common in adult COVID-19 patients, thrombotic microangiopathy as a part of endothelitis might play an important role in severe organ dysfunction. Thrombocytopenia-associated multiple organ failure (TAMOF) is a thrombotic microangiopathy syndrome that is associated with endothelial damage. Herein, we aim to report a pediatric TAMOF case related to SARS-CoV-2 infection which has been scarcely reported to date.

Case: A 7-month-old boy who became severely ill after being infected with SARS-CoV-2 required advanced critical care treatments such as continuous renal replacement therapy, therapeutic plasma exchange, and extracorporeal membrane oxygenation. A heart and lung biopsy obtained during sternotomy showed thrombotic microangiopathy. Despite early plasma exchange, mortality was inevitable because of severe liver failure.

Conclusions: This case report implies that SARS-CoV-2 infection could cause TAMOF in children. To the best of our knowledge, this is the second SARS-CoV-2-induced pediatric TAMOF case. More studies are needed to determine alternative treatments for patients with TAMOF who are resistant to conventional therapies.

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新生儿COVID-19致死性血栓性微血管病1例报告

背景:虽然大血管血栓形成在成人COVID-19患者中很常见，但血栓性微血管病变作为内皮炎的一部分可能在严重器官功能障碍中起重要作用。血小板减少相关的多器官衰竭(TAMOF)是一种与内皮损伤相关的血栓性微血管病变综合征。在此，我们的目的是报告一个与SARS-CoV-2感染相关的儿科TAMOF病例，这一病例迄今几乎没有报道。病例:一名7个月大的男婴感染SARS-CoV-2后病情严重，需要持续肾脏替代治疗、治疗性血浆置换和体外膜氧合等先进的重症监护治疗。胸骨切开术中进行的心肺活检显示血栓性微血管病变。尽管早期进行了血浆置换，但由于严重的肝功能衰竭，死亡是不可避免的。结论:本病例报告提示SARS-CoV-2感染可引起儿童TAMOF。据我们所知，这是第二例由sars - cov -2引起的小儿TAMOF病例。需要更多的研究来确定对传统治疗有耐药性的TAMOF患者的替代治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Turkish Journal of Pediatrics 医学-小儿科

CiteScore

1.40

自引率

0.00%

发文量

122

审稿时长

6-12 weeks

期刊介绍： The Turkish Journal of Pediatrics is a multidisciplinary, peer reviewed, open access journal that seeks to publish research to advance the field of Pediatrics. The Journal publishes original articles, case reports, review of the literature, short communications, clinicopathological exercises and letter to the editor in the field of pediatrics. Articles published in this journal are evaluated in an independent and unbiased, double blinded peer-reviewed fashion by an advisory committee.