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類固醇用於因敗血症引起的結合型高膽紅素血症：一病例報告
Other Title
Steroid Use in Sepsis-induced Conjugated Hyperbilirubinemia: Report of One Case
Type
article
Resource
Acta Paediatrica Taiwanica. 48(3): 146-148
Date Issued
2007-06
Author(s)
Subjects
萬芳醫院
科部：內科部
類別：期刊論文
Abstract
我們報告一個病例，一個女孩本身為急性淋巴球性白血病的病童，因葛蘭氏陰性菌（大腸桿菌）敗血症引起嚴重的結合型高膽紅素血症（全部膽紅素34.32mg/dl，直接型26.94mg/dl）。此病童接受靜脈內廣泛性抗生素治療，但膽紅素仍持續上升。當她出現意識模糊，倦怠和遲鈍的情形時，我們給予類固醇輔助治療(Hydrocortisone 8mg/kg/day)，而後黃疸和意識狀態很快就恢復了。基於上述發現，我們認為高劑量類固醇有助於輔助治療因葛蘭氏陰性菌敗血症引成的結合型高膽紅素血症。
We report a girl with acute lymphoblastic leukemia who developed severe conjugated hyperbilirubinemia (total bilirubin 34.32 mg/dl, direct bilirubin 26.94 mg/dl) following gram-negative (Escherichia coli) sepsis. Despite broad-spectrum antibiotics, her hyperbilirubinemia progressed. Her mental status deteriorated and steroid therapy (hydrocortisone 8 mg/kg/d) was initiated. Her condition then recovered rapidly. Based on our findings, we suggest that steroid may help to treat progressive conjugated hyperbilirubinemia due to gram-negative sepsis.
We report a girl with acute lymphoblastic leukemia who developed severe conjugated hyperbilirubinemia (total bilirubin 34.32 mg/dl, direct bilirubin 26.94 mg/dl) following gram-negative (Escherichia coli) sepsis. Despite broad-spectrum antibiotics, her hyperbilirubinemia progressed. Her mental status deteriorated and steroid therapy (hydrocortisone 8 mg/kg/d) was initiated. Her condition then recovered rapidly. Based on our findings, we suggest that steroid may help to treat progressive conjugated hyperbilirubinemia due to gram-negative sepsis.