重症登革热并血小板膜糖蛋白抗体阳性1例报道

新发传染病电子杂志 ›› 2018, Vol. 3 ›› Issue (2): 95-97.

重症登革热并血小板膜糖蛋白抗体阳性1例报道

林路平¹, 范慧敏¹, 李粤平¹, 陈谐捷¹, 赵令斋¹, 姚细安¹, 叶欣², 邓晶², 谭行华¹, 张复春¹

1.广州市第八人民医院,广州 510060;
2.广州市血液中心,广州 510060

收稿日期:2017-12-21 出版日期:2018-05-30 发布日期:2020-06-29
通讯作者: 张复春,Email: gz8hzfc@126.com
基金资助:
国家科技重大专项（2017ZX103055001-003）; 广州市健康医疗协同创新重大计划（201803040006）

Severe dengue with platelet membrane glycoprotein antibody positive: report of 1 case

LIN Lu-ping¹, FAN Hui-min¹, LI Yue-ping¹, CHEN Xie-jie¹, ZHAO Ling-zhai¹, YAO Xi-an¹, YE Xin², DENG Jing², TAN Xing-hua¹, ZHANG Fu-chun¹

1. Guangzhou 8th People's Hospital,Guangzhou 510060, China;
2. Guangzhou Blood Centre, Guangzhou 510060, China

Received:2017-12-21 Online:2018-05-30 Published:2020-06-29

摘要/Abstract

摘要： 目的为了解重症登革热并血小板糖膜蛋白抗体阳性的临床特征。方法对1例重症登革热并血小板膜糖蛋白抗体阳性患者的临床资料及救治过程进行回顾性分析。结果朱某,男,21岁,于2014年9月19日入院。急性起病,发热1天,体温最高38℃,病程第6天出现全身出血性皮疹、牙龈出血、便血、尿血等出血症状,入院后查血常规提示WBC：5.87×10⁹/L,NEU：2.71×10⁹/L,RBC：4.96×10¹²/L,HGB：151.00g/L,PLT：2.00×10⁹/L,HCT：43.3%;登革热抗体IgM阳性,登革病毒核酸阳性;诊断考虑重症登革热,输新鲜血小板2单位后1小时后复查PLT下降至：1.00×10⁹/L,HGB下降至107.00g/L,PLT查血小板膜糖蛋白抗体GPⅡb/Ⅲa阳性,给予大剂量激素、丙种球蛋白,连用3天后患者出血症状好转,血小板回升,病情好转。结论重症登革热合并血小板显著下降患者应注意检测血小板抗体。如血小板抗体阳性情况下输注血小板可出现严重出血。应用糖皮质激素、丙种球蛋白等可能有效。

关键词: 重症登革热, 血小板膜糖蛋白抗体, 病例报道

Abstract: Objective To understand the clinical features of severe dengue with platelet membrane glycoprotein antibody positive and to explore its clinical management. Methods The clinical data and treatment of a severe dengue fever case with positive platelet membrane glycoprotein antibody in our hospital were retrospectively analyzed. Results The 21-year old, male patient,with acute onset manifested one-day fever and systemic rash. 6 days after fever, the patient was found gingival bleeding and urine bleeding. The regular blood examination showed that HGB：151.00g/L, PLT：2.00×10⁹/L, HCT：43.3%. After infusion of platelets, platelet recovery was not obvious and the index of platelet dropped to 1.00×10⁹/L. Dengue fever antibody was found positive.The main treatment measures including absolute bed, acid inhibition and other comprehensive treatment. Platelet relative antibody were examined. The antibody GPIIb/Ⅲa was positive. Given the gamma globulin and hormone, the patient's platelets rebounded, the bleeding symptoms remission, and the platelets rebounded. Conclusion Severe Dengue could lead to severe bleeding.Platelet relative antibodies should be checked. Gamma globulin and glucocorticoid might be helpful. The timing of usage and doseneed further study.

Key words: Severe Dengue, Platelet membrane glycoprotein antibody, Case report

林路平, 范慧敏, 李粤平, 陈谐捷, 赵令斋, 姚细安, 叶欣, 邓晶, 谭行华, 张复春. 重症登革热并血小板膜糖蛋白抗体阳性1例报道[J]. 新发传染病电子杂志, 2018, 3(2): 95-97.

LIN Lu-ping, FAN Hui-min, LI Yue-ping, CHEN Xie-jie, ZHAO Ling-zhai, YAO Xi-an, YE Xin, DENG Jing, TAN Xing-hua, ZHANG Fu-chun. Severe dengue with platelet membrane glycoprotein antibody positive: report of 1 case[J]. Electronic Journal of Emerging Infectious Diseases, 2018, 3(2): 95-97.

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