重症百日咳のECMO管理中に二次性血栓性微小血管症の合併が疑われた乳児例
早期乳児の百日咳は重症化し体外式膜型人工肺（extracorporeal membrane oxygenation, ECMO）管理を要することがあり，死亡リスクが高い。また，ECMO管理中に血栓傾向を来たした場合には迅速な対応と原因検索が重要となる。症例は日齢46，男児。百日咳による無呼吸，呼吸不全，低酸素血症で当院に搬送され，ECMO管理を行うも，入院当初から逸脱酵素上昇と遊離ヘモグロビン，破砕赤血球を検出し，溶血と血栓傾向があると考えた。 ECMOの脱血管位置調整，回路交換でも溶血と血栓傾向は改善しなかった。血栓性微小血管症（thrombotic microangiopathy, TMA...
Saved in:
| Published in | 日本集中治療医学会雑誌 Vol. 29; no. 5; pp. 533 - 537 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本集中治療医学会
01.09.2022
|
| Online Access | Get full text |
| ISSN | 1340-7988 1882-966X |
| DOI | 10.3918/jsicm.29_533 |
Cover
| Abstract | 早期乳児の百日咳は重症化し体外式膜型人工肺（extracorporeal membrane oxygenation, ECMO）管理を要することがあり，死亡リスクが高い。また，ECMO管理中に血栓傾向を来たした場合には迅速な対応と原因検索が重要となる。症例は日齢46，男児。百日咳による無呼吸，呼吸不全，低酸素血症で当院に搬送され，ECMO管理を行うも，入院当初から逸脱酵素上昇と遊離ヘモグロビン，破砕赤血球を検出し，溶血と血栓傾向があると考えた。 ECMOの脱血管位置調整，回路交換でも溶血と血栓傾向は改善しなかった。血栓性微小血管症（thrombotic microangiopathy, TMA）の鑑別診断を進め，二次性TMAと判断した。集学的治療にもかかわらず患者は死亡した。早期乳児の百日咳でECMO管理を要した場合の血栓傾向では，二次性TMAも含め原因検索と早急な対応が重要である。 |
|---|---|
| AbstractList | 早期乳児の百日咳は重症化し体外式膜型人工肺（extracorporeal membrane oxygenation, ECMO）管理を要することがあり，死亡リスクが高い。また，ECMO管理中に血栓傾向を来たした場合には迅速な対応と原因検索が重要となる。症例は日齢46，男児。百日咳による無呼吸，呼吸不全，低酸素血症で当院に搬送され，ECMO管理を行うも，入院当初から逸脱酵素上昇と遊離ヘモグロビン，破砕赤血球を検出し，溶血と血栓傾向があると考えた。 ECMOの脱血管位置調整，回路交換でも溶血と血栓傾向は改善しなかった。血栓性微小血管症（thrombotic microangiopathy, TMA）の鑑別診断を進め，二次性TMAと判断した。集学的治療にもかかわらず患者は死亡した。早期乳児の百日咳でECMO管理を要した場合の血栓傾向では，二次性TMAも含め原因検索と早急な対応が重要である。 |
| Author | 青木, 一憲 潮見, 祐樹 黒澤, 寛史 |
| Author_xml | – sequence: 1 fullname: 青木, 一憲 organization: 兵庫県立こども病院小児集中治療科 – sequence: 1 fullname: 潮見, 祐樹 organization: 兵庫県立こども病院小児集中治療科 – sequence: 1 fullname: 黒澤, 寛史 organization: 兵庫県立こども病院小児集中治療科 |
| BookMark | eNo9kMtKw1AQhg9SwVq78zVSzyWXk6WWeoFKNwruwklyogltlaQbd01BW7DSqmBxpV2IC7UIRVDBvkxu-hamVtzM_P_MP7P4FkGmfljnACwjWCAqoiuOZxu1AlY1iZA5kEWUYkGV5b1MqokIBUWldAHkPc_WIcSygiAkWWB-t8-TQTu5mcSD--hyHPijUnG7koyGSf80fHsO_Mfwoxs_DePmw9ewGd9dpSKajKKXXmqnsUE7vYn6nfDzNfC7yfVF0OoFrW7g34bv4-ikH07OlsC8xaoez__1HNhdL-0UN4VyZWOruFoWHCxSUVAsnRJJxqapE8osUWUSQpKEKIKES7JuEkyhLpkG0ZXUcSMdI5hGsMUIh4TkwNrsr-M12D7Xjly7xtxjjbkN26hy7ReRNkU0LTNU_0vjgLmaw8gPvsSGfg |
| ContentType | Journal Article |
| Copyright | 2022 日本集中治療医学会 |
| Copyright_xml | – notice: 2022 日本集中治療医学会 |
| DOI | 10.3918/jsicm.29_533 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1882-966X |
| EndPage | 537 |
| ExternalDocumentID | article_jsicm_29_5_29_29_533_article_char_ja |
| GroupedDBID | 123 ABJNI ACGFS ALMA_UNASSIGNED_HOLDINGS CS3 EIHBH JSF KQ8 RJT |
| ID | FETCH-LOGICAL-j2484-7fb83562ddb38af49a5115518103e56bd3280b5dc3b76bdec03e101152fa3e033 |
| ISSN | 1340-7988 |
| IngestDate | Wed Sep 03 06:31:04 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | false |
| Issue | 5 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2484-7fb83562ddb38af49a5115518103e56bd3280b5dc3b76bdec03e101152fa3e033 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jsicm/29/5/29_29_533/_article/-char/ja |
| PageCount | 5 |
| ParticipantIDs | jstage_primary_article_jsicm_29_5_29_29_533_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2022/09/01 |
| PublicationDateYYYYMMDD | 2022-09-01 |
| PublicationDate_xml | – month: 09 year: 2022 text: 2022/09/01 day: 01 |
| PublicationDecade | 2020 |
| PublicationTitle | 日本集中治療医学会雑誌 |
| PublicationTitleAlternate | 日集中医誌 |
| PublicationYear | 2022 |
| Publisher | 一般社団法人 日本集中治療医学会 |
| Publisher_xml | – name: 一般社団法人 日本集中治療医学会 |
| References | 9) Mielcarek N, Hörnquist EH, Johansson BR, et al. nteraction of Bordetella pertussis with mast cells, modulation of cytokine secretion by pertussis toxin. Cell Microbiol 2001;3:181-8. 3) 日本腎臓学会，日本小児科学会；非典型溶血性尿毒症症候群診断基準改訂委員会．非典型溶血性尿毒症症候群（aHUS）診療ガイド2015. Available from: http://www.jpeds.or.jp/uploads/files/20160210aHUS_guide.pdf 7) Saida K, Ogura M, Kano Y, et al. Treatment of hemolytic uremic syndrome related to Bordetella pertussis infection -is plasma exchange or eculizumab use necessary?. BMC Nephrol 2018;19:365. 10) Abramson T, Kedem H, Relman DA. Proinflammatory and proapoptotic activities associated with Bordetella pertussis filamentous hemagglutinin. Infect Immun 2001;69:2650-8. 5) Chaturvedi S, Licht C, Langlois V. Hemolytic uremic syndrome caused by Bordetella pertussis infection. Pediatr Nephrol 2010;25:1361-4. 4) Pela I, Seracini D, Caprioli A, et al. Hemolytic uremic syndrome in an infant following Bordetella pertussis infection. Eur J Clin Microbiol Infect Dis 2006;25:515-7. 6) Cohen-Ganelin E, Davidovits M, Amir J, et al. Severe Bordetella pertussis infection associated with hemolytic uremic syndrome. Isr Med Assoc J 2012;14:456-8. 8) Noris M, Caprioli J, Bresin E, et al. Relative role of geneticcomplement abnormalities in sporadic and familial aHUS and their impact on clinical phenotype. Clin J Am Soc Nephrol 2010;5:1844-59. 1) Straney L, Schibler A, Ganeshalingham A, et al. Schlapbach LJ; Australian and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation and the Australian and New Zealand Intensive Care Society Paediatric Study Group. Burden and Outcomes of Severe Pertussis Infection in Critically Ill Infants. Pediatr Crit Care Med 2016;17:735-42. 2) Cherry JD, Wendorf K, Bregman B, et al. An Observational Study of SeverePertussis in 100 Infants ≤120 Days of Age. Pediatr Infect Dis J 2018;37;202-5. |
| References_xml | – reference: 10) Abramson T, Kedem H, Relman DA. Proinflammatory and proapoptotic activities associated with Bordetella pertussis filamentous hemagglutinin. Infect Immun 2001;69:2650-8. – reference: 4) Pela I, Seracini D, Caprioli A, et al. Hemolytic uremic syndrome in an infant following Bordetella pertussis infection. Eur J Clin Microbiol Infect Dis 2006;25:515-7. – reference: 5) Chaturvedi S, Licht C, Langlois V. Hemolytic uremic syndrome caused by Bordetella pertussis infection. Pediatr Nephrol 2010;25:1361-4. – reference: 9) Mielcarek N, Hörnquist EH, Johansson BR, et al. nteraction of Bordetella pertussis with mast cells, modulation of cytokine secretion by pertussis toxin. Cell Microbiol 2001;3:181-8. – reference: 8) Noris M, Caprioli J, Bresin E, et al. Relative role of geneticcomplement abnormalities in sporadic and familial aHUS and their impact on clinical phenotype. Clin J Am Soc Nephrol 2010;5:1844-59. – reference: 2) Cherry JD, Wendorf K, Bregman B, et al. An Observational Study of SeverePertussis in 100 Infants ≤120 Days of Age. Pediatr Infect Dis J 2018;37;202-5. – reference: 6) Cohen-Ganelin E, Davidovits M, Amir J, et al. Severe Bordetella pertussis infection associated with hemolytic uremic syndrome. Isr Med Assoc J 2012;14:456-8. – reference: 1) Straney L, Schibler A, Ganeshalingham A, et al. Schlapbach LJ; Australian and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation and the Australian and New Zealand Intensive Care Society Paediatric Study Group. Burden and Outcomes of Severe Pertussis Infection in Critically Ill Infants. Pediatr Crit Care Med 2016;17:735-42. – reference: 3) 日本腎臓学会，日本小児科学会；非典型溶血性尿毒症症候群診断基準改訂委員会．非典型溶血性尿毒症症候群（aHUS）診療ガイド2015. Available from: http://www.jpeds.or.jp/uploads/files/20160210aHUS_guide.pdf – reference: 7) Saida K, Ogura M, Kano Y, et al. Treatment of hemolytic uremic syndrome related to Bordetella pertussis infection -is plasma exchange or eculizumab use necessary?. BMC Nephrol 2018;19:365. |
| SSID | ssib002671003 ssib058493938 ssib002484714 ssib002671004 ssib002003987 ssib002227213 ssib002670218 ssib026645110 ssib003171117 ssj0064966 ssib002670219 |
| Score | 1.9114956 |
| Snippet | 早期乳児の百日咳は重症化し体外式膜型人工肺（extracorporeal membrane oxygenation, ECMO）管理を要することがあり，死亡リスクが高い。また，ECMO管理中に血栓傾向を... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 533 |
| Title | 重症百日咳のECMO管理中に二次性血栓性微小血管症の合併が疑われた乳児例 |
| URI | https://www.jstage.jst.go.jp/article/jsicm/29/5/29_29_533/_article/-char/ja |
| Volume | 29 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本集中治療医学会雑誌, 2022/09/01, Vol.29(5), pp.533-537 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1882-966X dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0064966 issn: 1340-7988 databaseCode: KQ8 dateStart: 19940101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3NaxQxFB9KBfEifuI3PZiTzLozmcwkeMrMzlKUKkILxcuyszMLLlhF2ounbkErWGlVsHjSHsSDWoQiqGD_mf3S_8L3kuw2LR6sehmSl5f3Xn7JTN6bSTKOczGowwOgSXM3qvOmG-Rl7vIiyNwCTxLhopxFGW5wnroeTs4EV2fZ7Nj4LWvV0sJ8Vmo8-O2-kr_pVaBBv-Iu2X307EgoECAN_QtX6GG4_lEfk1QQCOZ5haQRERGmMSFInJI0RIpkJGVE-CSmJKXgNhKZpsnUDeSTKZGeqlAmPCRpQGJOZGXIFyuKJDxBWTJRzCGujJCghmMW0lhUJoJaRQzVg3BMgOSqxWwr1eYam5SVwMyV0gqJmSlC7cAMjfEUxVcCdSIxPKKqagnVSEa4EoWUlPDY9r4tUCCRYKMAQRHvbn5IYsArNlCCIpSZKApDBqmZEyKkqY62QV3EajiAVUkFkTeqOA5mo0XjxlHRDn-I7UYkOGrgseZX1gqNM4c22vLBIi0f8Q40P1hYRZPQ5upQvnmr4_ujZWv6PrTM4Yi9VGBLhRx2SEyk6ljAVTAzHGJ56b_DaM2MFJeeCv0PxlKhaRieCf0rytF0al5g3bYXLKi5kekTT4ybxfRZP3tncCo83JXSgkfUnZIvaqNKu85EN3dcTbHVkA0vmr02LMRti7UWxE4H_CgM8e8m125aoTXuSuf2qww_8m3XNkC_zX5VEaE7vCdvH9WH52TRPXlrhYIXedaebvCL8WTA0VwJcYCggo6-gIaBUOssRrDrTTsIz2UbHHCcWxBGDpegKq94-ohz2ISzE1KDcdQZa9WPOQenzIKd407-c_npYH158Gq7v_6293yr097Ex89gc2Ow9qj75WOn_b77baX_YaO_-O7HxmL_zQtI9LY3e59WIYts68tQp7f2uPv9c6e9Mnj5rLO02lla6bRfd79u9R6udbefnHBmqul0MumaH7u4LYTVjZoZBH6hn-cZ5fVmIOoABR4N6ZVpwcIspz4vZyxv0CyCXNEAsoexq9-s06JM6UlnfO7uXHHKmYhywYAzCEUEsUkheMFgrvGyhpc3GIg97VzR-NTu6dN7avsZO2f-qfZZ59DOrX3OGZ-_v1CchxBmPrugxuIv9bgF7g |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E9%87%8D%E7%97%87%E7%99%BE%E6%97%A5%E5%92%B3%E3%81%AEECMO%E7%AE%A1%E7%90%86%E4%B8%AD%E3%81%AB%E4%BA%8C%E6%AC%A1%E6%80%A7%E8%A1%80%E6%A0%93%E6%80%A7%E5%BE%AE%E5%B0%8F%E8%A1%80%E7%AE%A1%E7%97%87%E3%81%AE%E5%90%88%E4%BD%B5%E3%81%8C%E7%96%91%E3%82%8F%E3%82%8C%E3%81%9F%E4%B9%B3%E5%85%90%E4%BE%8B&rft.jtitle=%E6%97%A5%E6%9C%AC%E9%9B%86%E4%B8%AD%E6%B2%BB%E7%99%82%E5%8C%BB%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E9%9D%92%E6%9C%A8%2C+%E4%B8%80%E6%86%B2&rft.au=%E6%BD%AE%E8%A6%8B%2C+%E7%A5%90%E6%A8%B9&rft.au=%E9%BB%92%E6%BE%A4%2C+%E5%AF%9B%E5%8F%B2&rft.date=2022-09-01&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E9%9B%86%E4%B8%AD%E6%B2%BB%E7%99%82%E5%8C%BB%E5%AD%A6%E4%BC%9A&rft.issn=1340-7988&rft.eissn=1882-966X&rft.volume=29&rft.issue=5&rft.spage=533&rft.epage=537&rft_id=info:doi/10.3918%2Fjsicm.29_533&rft.externalDocID=article_jsicm_29_5_29_29_533_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1340-7988&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1340-7988&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1340-7988&client=summon |