系统性红斑狼疮合并水痘患儿误诊及药学监护分析  

Analysis of Misdiagnosis and Pharmacological Monitoring of a Child with Systemic Lupus Erythematosus Complicated with Varicella Infection

作　　者：孟艳 刘福娟[2] 郭敬肖 MENG Yan;LIU Fujuan;GUO Jingxiao(Department of Pharmacy,Hebei Children's Hospital,Shijiazhuang 050031,China;Department of Nephrology and Immunology,Hebei Children's Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院药学部,石家庄050031 [2]河北省儿童医院肾脏免疫科,石家庄050031

出　　处：《临床误诊误治》2024年第21期24-27,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会科研基金项目(20231142)。

摘　　要：目的探讨临床药师参与系统性红斑狼疮(SLE)合并水痘误诊患儿药物治疗方案的价值。方法分析1例SLE合并水痘患儿的临床资料。结果1例患儿因呕吐、间断低热,误诊为“胃肠炎”,给予对症治疗效果不佳。院外误诊时间1月余。入院后经完善相关检查确诊为SLE、狼疮性肾炎、中度贫血、水痘,给予抗病毒治疗及糖皮质激素冲击治疗,临床药师参与治疗方案的评估与调整、重点关注药物疗效及不良反应的监测等,治疗27 d后病情稳定出院。患儿规律门诊随访,病情稳定。结论实施临床药师药学监护可确保患儿在糖皮质激素冲击治疗期间用药的安全性及有效性,为SLE重症病例提供个体化的药学服务。Objective To investigate the value of clinical pharmacists'participation in drug treatment of misdiagnosed children with systemic lupus erythematosus(SLE)complicated with varicella.Methods The clinical data of 1 SLE child with varicella were analyzed.Results One patient was misdiagnosed as gastroenteritis due to vomiting and intermittent low fever in a local clinic,and the symptomatic treatment was not effective.Out-of-hospital misdiagnosis lasted more than one month.After admission,the patient was diagnosed with SLE,lupus nephritis,moderate anemia,and varicella through relevant examination.Antiviral therapy and glucocorticoid shock therapy were given.Clinical pharmacists participated in the evaluation and adjustment of the treatment plan,with a focus on monitoring the efficacy and adverse reactions.The patient was discharged with stable condition at 27 d after treatment,and received regular outpatient follow-up,and the condition was stable.Conclusion Pharmaceutical monitoring by clinical pharmacists can ensure the safety and effectiveness of glucocorticoid therapy in children,and provide individualized pharmaceutical services for severe SLE patients.

关 键 词：红斑狼疮 系统性 水痘 误诊 胃肠炎 糖皮质激素类 抗病毒药 药学服务 

分 类 号：R593.241[医药卫生—内科学]