急性硬膜外血腫（AEDH）を契機に発見された免疫性血小板減少症（ITP）の1例
AEDHを契機に発見されたITPの1例を経験したので報告する．症例は14歳男児，早産・低出生体重児であり二絨毛膜二羊膜双胎（DD twin）の第二子として出生した．けいれん，意識障害で受診しAEDHを認め開頭血腫除去術を施行した．術中の出血量は1,500 mlであったが明らかな骨折線や活動性の出血は認めなかった．術後経過は良好であった．血小板数の低値遷延から血液疾患の合併を疑い，精査した結果ITPの診断に至った．...
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| Published in | 小児の脳神経 Vol. 49; no. 4; pp. 189 - 193 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本小児神経外科学会
2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-8023 2435-824X |
| DOI | 10.34544/jspn.49.4_189 |
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| Abstract | AEDHを契機に発見されたITPの1例を経験したので報告する．症例は14歳男児，早産・低出生体重児であり二絨毛膜二羊膜双胎（DD twin）の第二子として出生した．けいれん，意識障害で受診しAEDHを認め開頭血腫除去術を施行した．術中の出血量は1,500 mlであったが明らかな骨折線や活動性の出血は認めなかった．術後経過は良好であった．血小板数の低値遷延から血液疾患の合併を疑い，精査した結果ITPの診断に至った． |
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| AbstractList | AEDHを契機に発見されたITPの1例を経験したので報告する．症例は14歳男児，早産・低出生体重児であり二絨毛膜二羊膜双胎（DD twin）の第二子として出生した．けいれん，意識障害で受診しAEDHを認め開頭血腫除去術を施行した．術中の出血量は1,500 mlであったが明らかな骨折線や活動性の出血は認めなかった．術後経過は良好であった．血小板数の低値遷延から血液疾患の合併を疑い，精査した結果ITPの診断に至った． |
| Author | 長野, 拓郎 矢尾板, 裕之 齋藤, 太 小瀧, 祐 酒本, 海帆 |
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| References | [2] Andoh S, Matsuura C, Sakaeyama Y, Okonogi S, Node Y, Masuda H, Kondo K, Harada N, Nemoto M, Sugo N: Acute contrecoup epidural hematoma that developed without skull fracture in two adults: two case reports. J Med Case Rep 12: 166, 2018. [7] 早川勲 : 小児の頭部外傷．牧豊編 : 小児神経外科の進歩と展望．東京，にゅーろん社，1988, pp 33-41. [1] Adolfo F, George R, Buchanan: Occult hemorrhage in children with severe ITP. Am J Hematol 91: 3, 2016. [6] Hashimoto Y, Kajiwara S, Furuta K, Takeuchi Y, Morioka M: Pediatric acute epidural hematoma caused by contrecoup injury: illustrative case. J Neurosurg Case Lessons 3 (23), 2022. [12] 酒井道生，藤沢康司，小原明，白幡聡 : 小児ITPとHelicobacter pylori．日小血会誌17: 413-417, 2003. [5] Gallagher JP, Browder EJ: Extradural hematoma. Experience with 167 patients. J Neurosurg 29: 1-12, 1968. [10] Mitsuyama T, Ide M, Kawamura H: Acute epidural hematoma caused by contrecoup head injury case report. BioMed Central 44: 584-586, 2004. [3] Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger JE: Surgical management of acute epidural hematomas. Neurosurgery 58: S7-15; discussion Si-iv, 2006. [13] Zhang JY, Li Y, Ma YS, Sun XJ, Liu YZ, Yin YK, Hu B, Su MH, Li QL, Mi YC, et al: Clinical characteristics and prognostic factors in intracranial hemorrhage patients with hematological diseases. Ann Hematol 101: 2617-2625, 2022. [9] Kelton JG, Powers PJ, Carter CJ: A prospective study of the usefulness of the measurement of platelet-associated IgG for the diagnosis of idiopathic thrombocytopenic purpura. Blood 60: 1050-1053, 1982. [4] Fukai R, Takahashi K, Abe H, Higashiyama Y, Doi H, Takeuchi H, Tanaka F: Non-traumatic acute epidural hematoma in multiple sclerosis treated with fingolimod. Front Neurol 10: Article 763, 2019. [8] 石黒精，森麻希子，宮川義隆，今泉益栄，小林尚明，笹原洋二，内山徹，野村理，堀内清華，高橋幸博，他 : 日本小児血液・がん学会2022年小児免疫性血小板減少症診療ガイドライン．The Japanese Journal of Pediatric Hematology/Oncology 59: 50-57, 2022. [11] Neunert CE, Buchanan GR, Imbach P, Bolton-Maggs PH, Bennett CM, Neufeld EJ, Vesely SK, Adix L, Blanchette VS, Kühne T: Severe hemorrhage in children with newly diagnosed immune thrombocytopenic purpura. Blood 112: 4003-4008, 2008. |
| References_xml | – reference: [1] Adolfo F, George R, Buchanan: Occult hemorrhage in children with severe ITP. Am J Hematol 91: 3, 2016. – reference: [9] Kelton JG, Powers PJ, Carter CJ: A prospective study of the usefulness of the measurement of platelet-associated IgG for the diagnosis of idiopathic thrombocytopenic purpura. Blood 60: 1050-1053, 1982. – reference: [7] 早川勲 : 小児の頭部外傷．牧豊編 : 小児神経外科の進歩と展望．東京，にゅーろん社，1988, pp 33-41. – reference: [10] Mitsuyama T, Ide M, Kawamura H: Acute epidural hematoma caused by contrecoup head injury case report. BioMed Central 44: 584-586, 2004. – reference: [8] 石黒精，森麻希子，宮川義隆，今泉益栄，小林尚明，笹原洋二，内山徹，野村理，堀内清華，高橋幸博，他 : 日本小児血液・がん学会2022年小児免疫性血小板減少症診療ガイドライン．The Japanese Journal of Pediatric Hematology/Oncology 59: 50-57, 2022. – reference: [2] Andoh S, Matsuura C, Sakaeyama Y, Okonogi S, Node Y, Masuda H, Kondo K, Harada N, Nemoto M, Sugo N: Acute contrecoup epidural hematoma that developed without skull fracture in two adults: two case reports. J Med Case Rep 12: 166, 2018. – reference: [12] 酒井道生，藤沢康司，小原明，白幡聡 : 小児ITPとHelicobacter pylori．日小血会誌17: 413-417, 2003. – reference: [13] Zhang JY, Li Y, Ma YS, Sun XJ, Liu YZ, Yin YK, Hu B, Su MH, Li QL, Mi YC, et al: Clinical characteristics and prognostic factors in intracranial hemorrhage patients with hematological diseases. Ann Hematol 101: 2617-2625, 2022. – reference: [6] Hashimoto Y, Kajiwara S, Furuta K, Takeuchi Y, Morioka M: Pediatric acute epidural hematoma caused by contrecoup injury: illustrative case. J Neurosurg Case Lessons 3 (23), 2022. – reference: [5] Gallagher JP, Browder EJ: Extradural hematoma. Experience with 167 patients. J Neurosurg 29: 1-12, 1968. – reference: [11] Neunert CE, Buchanan GR, Imbach P, Bolton-Maggs PH, Bennett CM, Neufeld EJ, Vesely SK, Adix L, Blanchette VS, Kühne T: Severe hemorrhage in children with newly diagnosed immune thrombocytopenic purpura. Blood 112: 4003-4008, 2008. – reference: [4] Fukai R, Takahashi K, Abe H, Higashiyama Y, Doi H, Takeuchi H, Tanaka F: Non-traumatic acute epidural hematoma in multiple sclerosis treated with fingolimod. Front Neurol 10: Article 763, 2019. – reference: [3] Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger JE: Surgical management of acute epidural hematomas. Neurosurgery 58: S7-15; discussion Si-iv, 2006. |
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| Snippet | AEDHを契機に発見されたITPの1例を経験したので報告する．症例は14歳男児，早産・低出生体重児であり二絨毛膜二羊膜双胎（DD twin）の第二子として出生した．けいれん，意識障害で受診しAEDHを認め開頭血腫除去術を施行した．術中の出血量は1,500... |
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| SubjectTerms | acute epidural hematoma helicobacter pylori hematological diseases immune thrombocytopenia pediatric |
| Title | 急性硬膜外血腫（AEDH）を契機に発見された免疫性血小板減少症（ITP）の1例 |
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