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A Rare Case of Pneumoperitoneum in Pregnancy: Perforation of Tubercular ileal Ulcer 妊娠气腹1例:结核性回肠溃疡穿孔
Pub Date : 2021-10-30 DOI: 10.31579/2578-8965/086
Richmond Ronald Gomes
The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of intestinal tuberculosis can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. We present a 25 year old 17 weeks primi presented with peritonitis with solitary perforation of terminal ileum with miscarriage of fetus and subsequent surgical wedge resection of ileum and ileo-ileal anastomosis. Histology revealed presence of Langerhan’s cell with caseating granulomatous inflammation. There was no radiological evidence of pulmonary tuberculosis. Patient was started on anti-tubercular therapy and responded well. This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition.
尽管卡介苗接种有效,但世界范围内结核病的发病率仍在上升。感染结核病风险最大的人群是移民社区以及免疫功能低下的个体。肠结核的诊断往往是一个诊断难题,由于其非特异性和多样化的表现,往往模仿炎症性肠病或恶性肿瘤。游离穿孔是肠结核最可怕的并发症之一。回肠末端是最常见的穿孔部位,而大多数(90%)穿孔是孤立的。我们报告了一位25岁17周大的婴儿,因腹膜炎并发孤立性回肠末端穿孔并胎儿流产,随后手术楔形切除回肠和回肠-回肠吻合术。组织学显示朗格罕细胞伴干酪样肉芽肿性炎症。没有肺结核的放射学证据。患者开始接受抗结核治疗,效果良好。本病例强调了从回肠穿孔患者的边缘取活检标本的重要性,以避免这种情况的误诊。
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引用次数: 0
Consequences of Zuspan Protocol Applications in Eclampsia Pregnant Women and Seizures Zuspan方案应用于子痫孕妇和癫痫发作的后果
Pub Date : 2021-10-30 DOI: 10.31579/2578-8965/083
B. Aslan, F. Aydin, Özlem Moraloğlu
Backgraund: Magnesium sulfate is the preferred anticonvulsant in the prevention and control of eclamptic convulsions. The Zuspan Regime is one of the most popular protocols used. However, due to toxicity concerns, several low-dose regimens have been implemented, given the low body mass index of Asian women. In our hospital, Zuspan Protocol is generally applied. Objective: We aimed to compare the results, effectiveness and reliability of 6-hour and 12-hour intravenous (i.v) MgSO4 infusions in the Zuspan Protocol in our hospital. Methods and Materials: A total of 700 cases of eclampsia were examined and these cases were treated with the Zuspan Protocol. The patients in the first group received 6 hours of treatment (n: 400), while the second group (n: 300) received the 12-hour treatment with magnesium sulfate. Recurrent convulsion rates, maternal and perinatal results of both regimens were evaluated and compared using unpaired t-test and chi-square test, respectively, for continuous and categorical variables. Result: We detected 700 eclamptic cases among 50.620 births in our hospital during the 7-year working period and this rate was found as 80.5 % of 700 women were in the 19-30 age group. Despite the fact that MgSO4 was infused in 700 eclamptic pregnant women, the rate of seizures was found to be total 3.57 %. Conclusion: The 12-hour intravenous Zuspan Protocol was found to be more effective and more preventive and safer than the eclamptic seizure compared to the 6-hour Zuspan Protocol.
背景:硫酸镁是预防和控制子痫性惊厥的首选抗惊厥药。Zuspan制度是最常用的协议之一。然而,鉴于亚洲妇女的身体质量指数较低,出于对毒性的考虑,已经实施了几种低剂量方案。本院普遍采用Zuspan方案。目的:比较我院Zuspan方案中6小时静脉输注MgSO4和12小时静脉输注MgSO4的效果、有效性和可靠性。方法与材料:对700例子痫患者进行检查,并采用Zuspan方案进行治疗。第一组患者接受6小时治疗(n: 400),第二组患者接受12小时硫酸镁治疗(n: 300)。对连续变量和分类变量分别采用未配对t检验和卡方检验对两种方案的反复惊厥率、孕产妇和围产期结果进行评估和比较。结果:7年工作期间,在我院50.620例产妇中检出700例子痫,其中19 ~ 30岁产妇占80.5%。尽管对700例子痫孕妇进行了MgSO4输注,但癫痫发作的总发生率为3.57%。结论:与6小时静脉注射Zuspan方案相比,12小时静脉注射Zuspan方案比6小时静脉注射Zuspan方案更有效、更安全、更能预防子痫发作。
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引用次数: 0
COVID-19 Pregnancy and Fertility: A Narrative Review 2019冠状病毒病妊娠与生育:叙事回顾
Pub Date : 2021-10-30 DOI: 10.31579/2578-8965/097
Tiffany Field
Pregnant women are currently worrying about both the effects of COVID-19 infection as well as the vaccine on their fetus and newborn. This narrative review is a summary of the literature on COVID-19 psychological problems of pregnant women, and infection effects on the women, their fetuses and neonates. The psychological problems studies have consistently shown a prevalence of approximately 20-40% anxiety and depression in pregnant women during COVID-19. Although early pandemic research suggested that the severity of COVID infection and the clinical course for infected pregnant women was no worse than for non-pregnant infected women, later pandemic, larger sample studies and meta-analyses suggest that infected pregnant women have more obstetric complications and negative outcomes than pregnant women without infection. Greater prevalence of pre-eclampsia, fetal distress, premature rupture of the membranes and preterm delivery have been reported for pregnant women who are infected, especially during the third trimester. Older pregnant women and those with comorbidities including elevated BMI, diabetes and hypertension are also at greater risk for obstetric complications. Mixed data have been presented on vertical transmission of the virus to the fetus as well as questions about vertical transmission via reduced natural killer cells protecting the placenta and increased ACE-2 receptors. Although the neonatal infection rate has been relatively low, antibodies noted in some neonates (IgG and IgM) suggest intrauterine, delivery or postnatal transmission. The very limited data on vaccination during pregnancy suggest positive effects. Although the data are even more limited on vaccination and fertility, there are no known negative effects. Methodological limitations of this literature include the data having been cross-sectional and derived from samples of symptomatic, hospitalized pregnant women at different gestational ages and different times during the pandemic.
孕妇目前既担心COVID-19感染的影响,也担心疫苗对胎儿和新生儿的影响。本文对有关新冠肺炎孕妇心理问题及感染对孕妇、胎儿和新生儿影响的文献进行综述。有关心理问题的研究一直表明,在COVID-19期间,孕妇的焦虑和抑郁患病率约为20-40%。尽管早期的大流行研究表明,受感染孕妇的感染严重程度和临床病程并不比未感染的孕妇差,但后来的大流行、大样本研究和荟萃分析表明,受感染孕妇比未感染的孕妇有更多的产科并发症和负面结果。据报道,受感染的孕妇,特别是在妊娠晚期,更容易出现先兆子痫、胎儿窘迫、胎膜早破和早产。高龄孕妇和患有BMI升高、糖尿病和高血压等合并症的孕妇发生产科并发症的风险也更大。关于病毒向胎儿的垂直传播,以及关于通过保护胎盘的自然杀伤细胞减少和ACE-2受体增加进行垂直传播的问题,已经提出了不同的数据。虽然新生儿感染率相对较低,但在一些新生儿中发现的抗体(IgG和IgM)提示宫内、分娩或产后传播。关于怀孕期间接种疫苗的非常有限的数据表明有积极作用。虽然关于疫苗接种和生育的数据更加有限,但没有已知的负面影响。该文献的方法学局限性包括数据是横断面的,并且来自大流行期间不同胎龄和不同时间有症状的住院孕妇的样本。
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引用次数: 1
COVID 19 in Pregnancy: Immunology Savior or Culprit 怀孕期间的COVID - 19:免疫救世主还是罪魁祸首
Pub Date : 2021-10-30 DOI: 10.31579/2578-8965/074
B. Kaur
Corona pandemic has been a nightmare for health care, from the point of view of transmission, pathogenesis, diagnosis and treatment, everything in doldrums. Pregnancy in itself encompasses altered physiology, immunity and often is characterized by unpredicted bodily responses. The short review is an attempt to summarize the knowledge gained so far in context with COVID 19 infection in pregnancy. The paper highlights gaps in our present understanding and emphasize on more research for understanding the double edged sword - immune system and its response to COVID 19 infection in pregnant woman.
从传播、发病机制、诊断和治疗的角度来看,冠状病毒大流行一直是卫生保健的噩梦,一切都处于低迷状态。怀孕本身就包含了生理和免疫的改变,并且常常以无法预料的身体反应为特征。这篇简短的综述试图总结迄今为止在妊娠期COVID - 19感染方面获得的知识。本文强调了我们目前认识的空白,强调了更多的研究,以了解双刃剑-免疫系统及其对孕妇COVID - 19感染的反应。
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引用次数: 0
Arteriovenous Malformation of the Uterus: A Review and Update. 子宫动静脉畸形:回顾与最新进展。
Pub Date : 2021-10-30 DOI: 10.31579/2578-8965/085
A. Kodzo-Grey Venyo, E. Bakir
Arteriovenous malformation of the uterus (AVMU) is a very rare and uncommon condition, because it has been documented that less than 100 cases of AVMU have been reported in the literature. AVMU is potentially a life-threatening condition with regard to the fact that some cases of AVMU could manifest with profuse bleeding from the uterus via the vagina. AVMU could either be congenital AVMU which is less common or acquired AVMU with pregnancy noted to have a role to play in the pathogenesis of AVMUs. The true incidence of AVMU is stated to be difficult to ascertain in view of the fact that some cases of bleeding that have been caused by AVMU do tend to conservative, medical management and many of these AVMUs could remain undiagnosed. The most common manifestations of AVMUs tend to be abnormal uterine bleeding that could be episodic, intermittent, continuous, mild or torrential which could lead to severe anaemia or shock. Some AVMUs could be found incidentally based upon radiology imaging for a different condition. Other symptoms of AVMUs do include: Metrorrhagia; Menorrhagia; Bleeding following a miscarriage; Bleeding following dilatation and curettage; Bleeding subsequently after hysterectomy; Bleeding associated with trophoblastic disease; Bleeding following caesarean section; Post-partum haemorrhage; Intermittent vaginal bleeding; Continuous vaginal bleeding; Post-menopausal bleeding; Acute abdominal pain with hemoperitoneum; Pallor; Dizziness; Weakness; Drowsiness; Being unwell following delivery of a baby; Bleeding following therapeutic abortion; Tachycardia; Supra-pubic pain at times; hypotension. Diagnosis of AVMU tends to be made based upon radiology imaging with utilization of ultrasound scan / Doppler scan of the uterus and pelvis, Contrast Computed Tomography scan, and Contrast Magnetic Resonance Imaging Scan, as well as by selective angiography which tends to be ensued by treatment with embolization of the feeding vessels to the AVMU. The treatment of AVMUs these days has ranged between conservative and medical management that includes hormones for small AVMUs, Hysterectomy, which tends to be a definitive treatment that removes the AVMU but does leave the individual not being able to maintain her future fertility, as well as selective angiography and super-selective embolization of the uterine arterial branches feeding the AVMU, which does tend to maintain the future fertility of the patients and which has the advantage of being undertaken under local anaesthesia. Questions that should be on the minds of clinicians include should doppler ultrasound scan of the uterus be undertaken with regard to all women who develop persistent vaginal bleeding pursuant to or during management of miscarriage, considering that there are very few interventional radiologists in many hospitals. This means that selective angiography plus super-selective embolization cannot be undertaken in district hospitals should all women who have suspected AVMU that have
子宫动静脉畸形(AVMU)是一种非常罕见和不常见的疾病,因为文献报道的AVMU病例不到100例。AVMU是一种潜在的危及生命的疾病,因为一些AVMU病例可能表现为子宫经阴道大量出血。AVMU可能是不常见的先天性AVMU,也可能是在AVMU发病机制中起作用的妊娠获得性AVMU。由于一些由动静脉血栓栓塞引起的出血病例确实倾向于保守治疗,而且许多动静脉血栓栓塞可能仍未得到诊断,因此难以确定动静脉血栓栓塞的真实发生率。avmu最常见的表现往往是异常子宫出血,可发作性,间歇性,连续性,轻度或剧烈出血,可导致严重贫血或休克。一些avmu可以偶然发现基于放射成像的不同条件。动静脉血栓的其他症状包括:出血;月经过多;流产后出血;扩张和刮除后出血;子宫切除术后出血;与滋养层疾病相关的出血;剖宫产术后出血;产后出血;间歇性阴道出血;阴道持续出血;绝经后出血;急性腹痛伴腹膜出血;苍白;头晕;弱点;嗜睡;产后的:分娩后身体不适的;治疗性流产后出血;心动过速;有时耻骨上疼痛;低血压。AVMU的诊断往往基于放射学成像,利用子宫和骨盆的超声扫描/多普勒扫描,对比计算机断层扫描和对比磁共振成像扫描,以及选择性血管造影,通常随后进行AVMU供血血管栓塞治疗。目前对动静脉瘤的治疗包括保守治疗和医学治疗包括对小动静脉瘤的激素治疗,子宫切除术,这往往是一种明确的治疗方法,可以切除动静脉瘤但确实会使个体无法维持其未来的生育能力,还有选择性血管造影术和超选择性栓塞子宫动脉分支为动静脉瘤提供营养,这确实有助于维持病人未来的生育能力而且在局部麻醉下进行的优势。考虑到许多医院的介入放射科医生很少,临床医生应该考虑的问题包括,是否应该对流产后或流产期间出现持续阴道出血的所有妇女进行子宫多普勒超声扫描。这意味着选择性血管造影和超选择性栓塞不能在地区医院进行,是否应该将所有怀疑AVMU的严重出血可能需要手术的妇女转诊到三级医院,以便她们可能受益于选择性血管造影和栓塞她们的AVMU,而不是子宫切除术,使她们能够保持未来的生育能力?同样重要的是,让临床医生意识到动静脉瘤的存在,以便他们能够了解可能患有动静脉瘤的风险因素以及临床表现。临床医生还需要了解包括激素治疗在内的各种保守和期待治疗方法。临床医生还需要认识到这对有动静脉瘤的妇女未来生育能力的影响。尚未用于治疗AVMU的可能治疗方案包括:(a)放射学图像引导下的AVMU冷冻治疗,(b)放射学图像引导下的AVMU射频消融,(c)放射学图像引导下的AVMU不可逆电穿孔。全世界都需要培训更多的介入放射科医生包括发展中国家和一些发达国家这样他们就可以进行动静脉窦的栓塞治疗也可以为各种其他疾病提供各种介入放射治疗选择。
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引用次数: 0
Usage of Flaxseed Lignan in Menaposal Complaınts in Perımenaposal Women Patıents 亚麻籽木脂素在绝经期Complaınts Perımenaposal妇女Patıents中的应用
Pub Date : 2021-09-25 DOI: 10.31579/2578-8965/092
H. Alp
Lignans are phenylpropanoid dimers widely distributed in the plant kingdom. Flaxseed (Linum usitatissimum) is one of the richest sourcase of dietary lignans. Plant lignans comprise one of the two main groups of phytoestrogens the other group beigng the isoflavonoids. The major flax lignan is secoisolariciresinol diglucoside (SDG).Flaxseed is the richest food sourcase of SDG.Flaxseed also contains much smaller amounts of matairesinol, lariciresinol, and pineresinol. The plant lignans are converted by the intestinal microflora in the proximal or upper part of the large intestine to enterodiol (END) and enterolactone (ENL). Between 2017 and 2019, 26 female patients who applied for getat polk, obesity and perimenopausal complaints were included in the study. Demographic data of the patients were recorded. Age, weight, height, BMI and bloodT3,4, TSH, B12, Na, K levels were measured. Statistically average measurements were taken. Flaxseed was recommended for patients whose cholesterol levels were above the reference value. SDG has antioksidant activity.It also may have hypoglycemic, hypocholesterolemic, estrogenic,anti-estrogenic, anticancer, antiproliferative and renoprotective properties.
木脂素是广泛分布于植物界的苯丙二聚体。亚麻籽(Linum usitatissimum)是膳食中木脂素最丰富的来源之一。植物木脂素是植物雌激素的两大类之一,另一类是异黄酮。主要的亚麻木脂素是第二异脂树脂醇二葡糖苷(SDG)。亚麻籽是可持续发展目标最丰富的食物来源。亚麻籽还含有少量的松脂醇、松脂醇和松脂醇。植物木脂素通过大肠近端或上部的肠道菌群转化为肠二醇(END)和肠内酯(ENL)。在2017年至2019年期间,26名申请减肥、肥胖和围绝经期投诉的女性患者被纳入研究。记录患者的人口统计资料。测定年龄、体重、身高、BMI及血液t3、4、TSH、B12、Na、K水平。采用统计平均测量。建议胆固醇水平高于参考值的患者服用亚麻籽。可持续发展目标具有抗氧化活性。它还可能具有降血糖、降胆固醇、雌激素、抗雌激素、抗癌、抗增殖和保护肾的特性。
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引用次数: 0
Effectiveness the perfusion of Endometrial and Subendometrial and Endometrial volume on the endometrial receptivity of FET Cycles 子宫内膜和亚内膜灌注及子宫内膜体积对FET周期子宫内膜容受性的影响
Pub Date : 2021-09-25 DOI: 10.31579/2578-8965/067
V. Hazari, F. Sarvi, A. Alyasin, M. Agha-Hosseini, Sedigheh Hosseinimousa
Objective: this study was effects of endometrial and subendometrial blood perfusion and endometrial volume on endometrial receptivity in frozen embryo transfer (FET) cycles. Materials and methods: This prospective observational cohort study, that on infertile women who referred for FET to Shariati Hospital and Omid Infertility Clinic in Tehran (Iran) .112 patients selected among eligible women with good quality embryos. After homogenization, participants underwent endometrial preparation for hormone replacement therapy (HRT) according to a similar routine protocol. On the day of the FET, they underwent a thorough ultrasound examination for possible effective parameters. Subsequently, one to two good quality blastocysts were transferred, and the pregnancy outcomes were monitored. Results: In vitro fertilization (IVF) was performed on 112 patients with a mean age of 33.93±4.93 years. Although, serum β-HCG level was used to confirm pregnancy. Accordingly, out of 112 participating patients, 50 (44.6%) became pregnant after IVF. Based on the results of this study, the endometrial blood flow was significantly different between the two groups of pregnant and non-pregnant women, so that a higher pregnancy rate was observed in participants with multi-focal and spare endometrial blood flows (P<0.05). Additionally, a significant relationship between endometrial blood flow and pregnancy outcome so that there was more ongoing pregnancy rates in those with multi-focal and spare endometrial blood flows (P<0.05). But the endometrial variables of volume, length, width, thickness and pattern were not significantly different between the two groups of pregnant and non-pregnant women. Moreover, contextual parameters had no significant relationship with pregnancy outcome (P>0.05). Endometrial measurement indices were also ineffective on pregnancy outcomes and no significant difference was there between the groups (P>0.05). Conclusion: Collectively, the endometrial blood flow can play an effective role in improving pregnancy event and its stability after IVF, but the endometrial volume was unable to predict pregnancy event and its stability after IVF.
目的:探讨冷冻胚胎移植(FET)周期中子宫内膜和子宫内膜下血流灌注及子宫内膜体积对子宫内膜容受性的影响。材料和方法:本前瞻性观察队列研究,在德黑兰sharati医院和Omid不孕不育诊所转诊接受FET治疗的不孕妇女中选择了112例具有优质胚胎的合格妇女。匀浆后,参与者按照类似的常规方案进行子宫内膜准备激素替代治疗(HRT)。在FET当天,他们接受了彻底的超声检查,以寻找可能的有效参数。随后,移植1 ~ 2个优质囊胚,监测妊娠结局。结果:112例患者行体外受精,平均年龄33.93±4.93岁。虽然,血清β-HCG水平被用来确认妊娠。因此,112名参与调查的患者中,50名(44.6%)在体外受精后怀孕。本研究结果显示,妊娠组和非妊娠组的子宫内膜血流量有显著性差异,多灶性和子宫内膜血流量空闲的受试者妊娠率更高(P0.05)。子宫内膜测量指标对妊娠结局无显著影响,组间差异无统计学意义(P < 0.05)。结论:综上所述,子宫内膜血流量可有效改善IVF后妊娠事件及其稳定性,但子宫内膜体积不能预测IVF后妊娠事件及其稳定性。
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引用次数: 0
Left Retroaortic Renal Vein and Superior Mesenteric Artery Vascular Lesion Risk 左主动脉后肾静脉和肠系膜上动脉血管病变风险
Pub Date : 2021-09-25 DOI: 10.31579/2578-8965/087
M. Gorostidi, C. Villalaín, Daniel Rodriguez, A. Lekuona, I. Diez-Itza
To highlight the importance of preoperative assessment of imaging studies to rule out vascular abnormalities involving high bleeding risk in para-aortic lymphadenectomy for gynecological cancer.
强调术前评估影像学检查的重要性,以排除妇科肿瘤主动脉旁淋巴结切除术中血管异常伴高危出血的可能性。
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引用次数: 0
Evaluation of Oxidative Stress in Azoxymethane-induced Colon Cancerous Fischer Rats 氮氧甲烷诱导结肠癌Fischer大鼠氧化应激的评价
Pub Date : 2021-09-25 DOI: 10.31579/2578-8965/076
J. N. Lavanya Latha, V. Kavitha, B. Vijayalakshmi
Objective: to study the redox status of normal colon and aberrant crypts formed in azoxymethane induced colon cancerous fischer rats. Methods A total of 16 five-week-old male Fisher 344 rats (Rattus norvegicus), weighing approximately 90–100 grams were housed individually in plastic cages with wood-chip bedding. The animals were acclimatized for 1 week and fed with an American Institute of Nutrition (AIN-93G) diet ad libitum. Their protein oxidation, DNA damage, lipid peroxidation and antioxidants, glutathione (GSH), and antioxidative enzymes in serum were detected. Results The levels of protein oxidation Sand lipid peroxidation were significantly higher in the study group than in the control group (P<0.01). However, the mean serum level of MDA and conjugated diene was lower in the study group than in the control group (P<0.01). The activity of antioxidative enzymes was significantly decreased in the study group compared to control group (P<0.01). Conclusion Colorectal cancer is associated with oxidative stress, and assessment of oxidative stress and given antioxidants is important for the treatment and prevention of colorectal cancer.
目的:研究偶氮氧甲烷诱导的结肠癌fischer大鼠正常结肠和异常隐窝的氧化还原状态。方法选取16只5周龄雄性褐家鼠(Rattus norvegicus),体重约90 ~ 100 g,分别饲养于塑料笼中,铺有木屑垫层。驯化1周后,饲喂美国营养学会(AIN-93G)日粮。检测血清中蛋白质氧化、DNA损伤、脂质过氧化及抗氧化剂、谷胱甘肽(GSH)、抗氧化酶的含量。结果研究组蛋白质氧化和脂质过氧化水平显著高于对照组(P<0.01)。研究组血清丙二醛和偶联二烯平均水平低于对照组(P<0.01)。研究组抗氧化酶活性较对照组显著降低(P<0.01)。结论结直肠癌与氧化应激有关,评估氧化应激水平及给予抗氧化剂对结直肠癌的治疗和预防具有重要意义。
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引用次数: 0
Macrophage Activation Syndrome Discovered During Pregnancy: Case Report 妊娠期发现巨噬细胞激活综合征:病例报告
Pub Date : 2021-09-25 DOI: 10.31579/2578-8965/081
M. Serraj Andaloussi, Hayat Midyani, C. Khalloufi, A. Lamrissi, K. Fichtali, S. Bouhya, Salah Hayar, Ihsane Moussaid, S. El Youssoufi, S. Salmi
Macrophage activation syndrome (MAS) or Haemophagocytic syndrome (HPS) results from an inappropriate stimulation of macrophages in bone marrow and lymphoid organs, leading to haemophagocytosis and hypercytokinemia. HPS may be primitive, essentially in pediatric population, or secondary to malignancy, infection or autoimmune disease. This disease is rare and prognosis is poor. The diagnosis of hemophagocytic syndrome remains a challenge especially during pregnancy. We report a case collected at the Elharouchimaternity service, taken in charge jointly with its intensive care unit, of a 26-year-old patient with no pathological history leading to an unsuccessful pregnancy presumed at 5 months in whom the MAS syndrome was retained due to pancytopenia. , hyperferitinemia, hypertriglyceridemia with the presence of a few hemophagocytes in the myelogram with a good evolution under bolus of solumedrol and symptomatic treatment. We discuss through this case the diagnostic difficulties, the obstetric complications as well as the options therapeutic.
巨噬细胞激活综合征(Macrophage activation syndrome, MAS)或噬血细胞综合征(Haemophagocytic syndrome, HPS)是由于骨髓和淋巴器官中巨噬细胞受到不适当的刺激,导致噬血细胞增多和高细胞因子血症。HPS可能是原始的,主要发生在儿科人群中,也可能继发于恶性肿瘤、感染或自身免疫性疾病。本病罕见,预后差。噬血细胞综合征的诊断仍然是一个挑战,特别是在怀孕期间。我们报告一个病例收集在elharouchem产科服务,联合负责其重症监护病房,一个26岁的患者没有病理史导致妊娠失败推定在5个月,MAS综合征保留由于全血细胞减少症。高铁血症、高甘油三酯血症,骨髓图中有少量噬血细胞,在静脉注射和对症治疗下进展良好。我们通过这个病例讨论诊断困难,产科并发症以及治疗的选择。
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引用次数: 0
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Obstetrics Gynecology and Reproductive Sciences
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