婴儿突发皮肤紫癜

Unexpected cutaneous purpura in an infant

摘要:

患儿，男，2个月，因发现皮肤紫癜、血小板减少2d就诊，体查发现背部紫红色肿块，软组织彩超提示组织内丰富血流信号，骨髓细胞学提示巨核细胞增多，经激素及丙种球蛋白治疗后血小板迅速上升并维持在正常；同时口服普萘洛尔，随访4个月，患儿背部瘤体明显减小。血管瘤和免疫性血小板减少症诊断明确。对于血管瘤伴血小板减少的患者，应增强对血管瘤血小板减少症 （KMS）的认识，拓展思路，理顺血小板减少与血管瘤的关系，警惕其它原因所致的血小板减少。

Abstract:

A two-month-old boy visited the hospital due to unexpected cutaneous purpura and thrombocytopenia for 2 days. The physical examination revealed a purple mass on the back. The soft tissue color Doppler ultrasound showed rich blood signals in the tissue, and the results of bone marrow puncture indicated an increased number of megakaryocytes. After the treatment with hormone and gamma globulin, the platelet count rapidly increased and maintained at a normal level. Meanwhile, the boy was given oral administration of propranolol. He was followed up for 4 months and the volume of the mass on the back was reduced significantly. He had a definite diagnosis of hemangioma and immune thrombocytopenia. As for the patients with hemangioma complicated by thrombocytopenia, knowledge of Kasabach-Merritt syndrome should be enhanced and there should be a clarification of the association between thrombocytopenia and hemangioma. There should also be an alertness for thrombocytopenia of other causes.