Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 383-386.doi: 10.24920/003663

• 病例报告 • 上一篇    下一篇

3例病毒相关性儿童横纹肌溶解症的临床分析与文献复习

具杨花,乔红梅,张影,李亚男()   

  1. 吉林大学第一医院儿科,长春,130021 中国
  • 收稿日期:2019-09-23 接受日期:2020-03-14 出版日期:2020-12-31 发布日期:2021-01-08
  • 通讯作者: 李亚男 E-mail:lyanan2008@sina.com

Three Cases of Rhabdomyolysis Induced by Viral Infections in Children and Literature Review

Yanghua Ju,Hongmei Qiao,Ying Zhang,Yanan Li()   

  1. Department of Pediatrics, the First Hospital of Jilin University, Changchun 130021, China
  • Received:2019-09-23 Accepted:2020-03-14 Published:2020-12-31 Online:2021-01-08
  • Contact: Yanan Li E-mail:lyanan2008@sina.com

摘要:

回顾分析了3例由不同病毒感染所致的儿童横纹肌溶解症患者的临床症状、体征、酶学变化和肌肉活检病理表现、诊治经过及病情转归。病例1为甲型流感病毒感染的11岁男孩,主要表现为发热、咳嗽和肌痛。经积极抗病毒、水化、碱化治疗,患者病情完全恢复。病例2为EB病毒感染的10岁女孩,有明显的肌肉疼痛和肌无力症状,肌酸激酶明显升高;经积极补液和抗感染治疗,患者恢复正常。病例3为人巨细胞病毒感染的15岁男孩,以反复发热为主要症状,并伴有肌痛、面部水肿;抗菌治疗无效,出现呼吸肌无力和多脏器损伤;经抗病毒、呼吸支持和血液滤过治疗后,病情好转,无后遗症。结合文献回顾,尽管流感病毒、EB病毒和巨细胞病毒在儿童中很少引起横纹肌溶解症,但应引起重视。经早期诊断和治疗,上述病毒引起的横纹肌溶解症的预后良好。

关键词: 横纹肌溶解, 甲型流感病毒, 巨细胞病毒, EB病毒, 儿童

Abstract:

The clinical data of 3 patients with rhabdomyolysis (RM) caused by different viral infections were retrospectively reviewed. The diagnoses were established according to the clinical symptoms, physical signs, myocardial enzymes, and muscle biopsy. Case 1 was a 11-year-old boy with influenza A virus infection, whose major symptoms were fever, cough and myalgia. After the treatment of active anti-virus, hydration, and alkalinization, the patient completely recovered. Case 2 was a 10-year-old girl with Epstein-Barr (EB) virus infection who had significant musculoskeletal pain and muscle weakness symptoms with significantly elevated serum creatine kinase. After active hydration and anti-infective treatment, the patient’s condition returned to normal. Case 3 was a 15-year-old boy with human cytomegalovirus infection, whose symptoms were mainly repeated fever, accompanied by myalgia and facial edema. Antibacterial therapy was ineffective, and the disease progressed with respiratory muscle weakness and multiple organ injuries. After antiviral treatment, respiratory support and hemofiltration, the symptoms relieved and patient recovered without sequela. With literature review, we believe that although influenza virus, Epstein-Barr virus and cytomegalovirus rarely cause RM in children, it should be attached attention to. With early diagnosis and treatment, the prognosis is favorable.

Key words: rhabdomyolysis, influenza A virus, cytomegalovirus, Epstein-Barr virus, children

基金资助: 国家自然科学基金(81770026);吉林省自然科学基金(20180101157JC)

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