两例胎粪吸入综合征导致的早产儿类白血病反应。
Two cases of Leukemoid reaction in premature infants caused by fetal inflammatory response syndrome.
机构信息
Department of Neonatology, Children's Medical Center, The First Hospital of Jilin University, NO.1 Xinmin Street, Changchun, 130012, China.
出版信息
BMC Pediatr. 2024 Aug 24;24(1):546. doi: 10.1186/s12887-024-05006-4.
BACKGROUND
Fetal inflammatory response syndrome (FIRS) is a systemic inflammatory response caused by the activation of the fetal immune system. The serological diagnostic criterion for fetal inflammatory response syndrome is a cord blood interleukin-6 concentration that exceeds 11 pg/mL, while pathologic evidence indicates the presence of funisitis or chorionic vasculitis. It can affect all systems of the fetus. Alterations in patients' hematopoietic system are primarily reflected by changes in peripheral blood leukocyte and neutrophil counts.
CASE PRESENTATION
We performed placental pathology to identify FIRS and showed two cases of neonatal leukemoid reaction caused by FIRS. These two babies' alterations in hematopoietic system resolves spontaneously with the inflammation relief, without specific interventions. During the 16‑month and14- month follow‑up period, their motor and intellectual development was normal.
CONCLUSIONS
. Neonatal leukemoid reaction is a reactive disease characterized by abnormal blood parameters similar to those of leukemia, but not leukemia. It is an aberrant hematopoietic response that typically resolves spontaneously with cause relief without requiring specific interventions.
背景
胎儿炎症反应综合征（FIRS）是胎儿免疫系统激活引起的全身炎症反应。胎儿炎症反应综合征的血清学诊断标准为脐血白细胞介素-6 浓度超过 11pg/ml，而病理证据表明存在脐带炎或绒毛膜血管炎。它可影响胎儿的所有系统。患者造血系统的改变主要反映在外周血白细胞和中性粒细胞计数的变化上。
病例介绍
我们进行了胎盘病理学检查以确定 FIRS，并显示了两例由 FIRS 引起的新生儿类白血病反应。这两个婴儿的造血系统改变随着炎症的缓解而自发恢复，无需特定干预。在 16 个月和 14 个月的随访期间，他们的运动和智力发育正常。
结论
新生儿类白血病反应是一种以类似于白血病的血液参数异常为特征的反应性疾病，但不是白血病。这是一种异常的造血反应，通常随着病因的缓解而自发恢复，无需特定干预。
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