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Adenovirus pneumonia with hemophagocytic lymphohistiocytosis in children: a clinical analysis of 7 children / 中国当代儿科杂志
Chinese Journal of Contemporary Pediatrics ; (12): 749-754, 2020.
Artigo em Chinês | WPRIM | ID: wpr-828672
ABSTRACT
OBJECTIVE@#To study the clinical features of children with adenovirus pneumonia and hemophagocytic lymphohistiocytosis (HLH).@*METHODS@#A retrospective analysis was performed on the mediacal data of 7 children with adenovirus pneumonia and HLH from March to September, 2019.@*RESULTS@#The age of these children ranged from 11 months to 5 years, and among these children, 5 were aged <2 years and 5 were boys. None of these children had underlying diseases. All children were hospitalized due to persistent high fever and cough, and the peak temperature of fever was 39°C to 41°C. With disease progression, 7 children developed hepatomegaly and 6 developed splenomegaly. Routine blood test results showed reductions in two or three lineages of blood cells, with increases in serum ferritin (SF), C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH). Phagocytosis of blood cells was observed in 6 children. Radiological examination of lungs showed pneumonia changes. All 7 children were diagnosed with human adenovirus type 7 infection based on pathogenic metagenome detection. No abnormality was found by HLH gene detection and the children were diagnosed with secondary HLH. All children received intravenous immunoglobulin. Among these children, 4 received dexamethasone and etoposide chemotherapy, 3 received dexamethasone alone, and 4 received plasma exchange. Of the 7 children, 2 died and 5 were recovered. Compared with those who survived, the children who died had significantly greater reductions in the three lineages of blood cells and significantly greater increases in serum levels of CRP, PCT, SF, and LDH.@*CONCLUSIONS@#The children with adenovirus pneumonia and HLH have main clinical features of persistent high fever, progressive reductions in two or three lineages of peripheral blood cells, and involvement of other organ systems, including hepatosplenomegaly. Significant increases in serum levels of CRP, PCT, SF, and LDH may suggest a poor prognosis.
Assuntos
Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Adenoviridae / Estudos Retrospectivos / Imunoglobulinas Intravenosas / Linfo-Histiocitose Hemofagocítica / Etoposídeo Tipo de estudo: Estudo observacional Limite: Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino Idioma: Chinês Revista: Chinese Journal of Contemporary Pediatrics Ano de publicação: 2020 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Adenoviridae / Estudos Retrospectivos / Imunoglobulinas Intravenosas / Linfo-Histiocitose Hemofagocítica / Etoposídeo Tipo de estudo: Estudo observacional Limite: Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino Idioma: Chinês Revista: Chinese Journal of Contemporary Pediatrics Ano de publicação: 2020 Tipo de documento: Artigo