Pediatric History-Yao Syndrome
Introduction
Introduction to Pediatric History-Just Syndrome Pediatric history-synthesis syndrome is also known as mucocutaneocular syndrome, Stevens-Johnson Syndrome, exudative polymorphous erythema, malignant bullous erythema, Fuchs syndrome, and the like. This syndrome is a more serious type of polymorphous exudative erythema syndrome, mainly characterized by polymorphic skin lesions at various stages of the skin, mucosal lesions of the mouth and eyes and symptoms of systemic poisoning. basic knowledge The proportion of illness: 0.0002% Susceptible people: children Mode of infection: non-infectious Complications: pneumonia, myocarditis, cerebral edema, hematuria
Cause
Pediatric history - the cause of the syndrome
(1) Causes of the disease
The etiology of this disease is not fully understood. Some people think that it may be a bacterial or viral infection, an allergic disease caused by drugs.
(two) pathogenesis
It is generally considered to be an allergic reaction of the body to certain antigens. The affirmative pathogenic factors are as follows.
1. Infection (bacteria, virus, mycoplasma): often occurs after a cold, especially related to herpes virus infection, some patients with pneumonia, serum condensate titer rise and separation into Mycoplasma pneumoniae.
2. Drug allergy: Some people think that this disease is a heavy drug rash, related drugs are penicillin, sulfonamide and other antibacterial drugs; Baotaisong, wille, amalgam, codeine, barbiturates, anti-epileptic drugs.
3. Others: Occasionally related to vaccination, endocrine disorders, malignant tumors, etc.
Prevention
Pediatric history-syndromic syndrome prevention
Active prevention and treatment of various infections, do a good job in skin and mucous membrane care of children, do a good job of vaccination, strengthen nutrition and enhance physical fitness. For allergic skin diseases, we should thoroughly search for allergens, avoid contact, avoid eating and avoid Foods that are related to or can aggravate the disease, such as fish, shrimp, crab and other heterosexual proteins, such as allergic to drugs, should try to find sensitizing drugs, and explain the situation to patients and their families, when visiting the hospital, should also be directed to the doctor In order to achieve cooperation, the drug and the drug containing the drug component sensitized to the drug are no longer used.
Complication
Pediatric history-syndromic syndrome complications Complications pneumonia myocarditis cerebral edema hematuria
Can have febrile seizures, other can be complicated by otitis media, secondary bronchitis, pneumonia, arthritis, myocarditis, cerebral edema, liver damage, etc., such as kidney involvement, proteinuria, hematuria, increased urea nitrogen, etc., severe cases may have intestinal Mucosal ulcer bleeding, necrotizing pancreatitis, occasional myocarditis, severe cases often have circulatory failure, poor prognosis.
Symptom
Pediatric history-about syndrome symptoms Common symptoms Mucosal damage Sounds deafness, abdominal pain, high fever, diarrhea, pharyngeal difficulty, difficulty breathing, urinary dysfunction
This syndrome is more common in young and childhood, the main clinical manifestations are as follows.
1. Systemic poisoning symptoms
The disease is high fever, the body temperature can be as high as 38 ~ 41 ° C, infants can have febrile seizures, fever lasts about 2 to 3 weeks, skin occurs within 1 to 10 days, mucosal damage, with the disease into the extreme phase, the systemic symptoms are getting worse, about One third of the cases were accompanied by pneumonia, X-ray chest fluoroscopy was patchy shadows, a small number of arthritis, occasional myocarditis and glomerulonephritis occurred, and extremely severe cases often suffered from circulatory failure.
2. Extensive skin lesions
Limbs, torso, head and face, even throughout the body, erythema, blisters, typical and varying sizes of bullous polymorphic erythema, Nissl's sign negative, repeated within 1 to 2 weeks, severely merged into large pieces, after foaming A large number of serous exudation and erosion surface, shaped like a second degree burn, if there is no secondary infection after 1 to 4 weeks of crusting and scaling, no scar, skin lesions can be extended for 3 to 6 weeks.
3. Mucosal damage
(1) digestive tract performance: almost all cases have stomatitis, manifested as large bubbles, erosion, bleeding and scarring, dysphagia due to pain and hooliganism, a small number of cases of stomach, small intestine and even rectal anus also have mucosal erosion, and appear Abdominal pain and diarrhea; oral mucosal damage, domestic Wang Shanglan and other foreign data are said to have an incidence of 100%.
(2) Ocular symptoms: Maureen et al believe that acute conjunctivitis, periorbital swelling and spleen caused by shame and other eye manifestations of the early symptoms of the disease, in addition to corneal edema, iridocyclitis, anterior chamber empyema, etc. The incidence of ocular inflammation is 80% to 90%.
(3) urinary system performance: cystitis, vulva and urethral stomatitis caused dysuria.
(4) Respiratory manifestations: nasal vestibule and even throat, trachea, bronchial mucosa erosion, hoarseness and difficulty breathing.
Examine
Pediatric history-about syndrome examination
Increased white blood cells, eosinophils can be increased, erythrocyte sedimentation rate is accelerated, anti-"O" value is increased, and C protein is positive.
Chest X-ray examination to determine whether there is lung disease, accompanied by pneumonia, X-ray chest perspective is patchy shadow, other according to clinical needs to choose B-ultrasound, ECG, brain CT and other examinations.
Diagnosis
Diagnostic identification of pediatric history-synaptic syndrome
diagnosis
Based on clinical performance, combined with laboratory findings, a diagnosis can be made.
Differential diagnosis
1. Pemphigus: After slow, the symptoms of systemic poisoning are mild, the blister base has no inflammation, the Nissl sign is positive, and the cytological examination shows the presence or absence of pustular cells.
2. Drug dermatitis: Bullous polymorphic erythema type is similar to this disease, but has a history of medication, and the prognosis is good.
3. Toxic epidermal necrolysis (Lell disease): Symptoms are more serious than this disease, the incidence is sharp, after rapid, the skin lesions are second-degree scald extensive exfoliation, due to rapid necrosis of the epidermis, the skin is dark purple red, Nepal Positive sign.
