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1例21个月男性患儿因上呼吸道感染给予尼美舒利颗粒50 mg分2次服用(间隔15 h)。第1次服药后3 h,患儿出现抽搐、面色苍白、小便变黄。第2次服药后15 min再次出现抽搐,面色苍白进行性加重,小便呈浓茶色。入院后实验室检查:C反应蛋白79.0 mg/L;白细胞计数35.6×109/L,中性粒细胞计数27.1×109/L,血红蛋白33 g/L,血小板计数471×109/L;凝血酶时间17.2 s,凝血酶原时间20.4 s,国际标准化比值1.63,活化部分凝血活酶时间27.5 s,纤维蛋白原2.95 g/L。予心电监护、吸氧,静脉滴注地塞米松、甲泼尼龙及人免疫球蛋白,静滴碳酸氢钠,输注洗涤红细胞。患儿病情加重,出现昏迷、四肢抽动,血压131/103 mm Hg(1 mm Hg=0.133 kPa),心率153次/min。予血浆置换、抗感染、免疫抑制、水化及营养支持治疗,患儿病情好转。入院第8天复查血常规:白细胞计数7.0×109/L,中性粒细胞计数5.3×109/L,血红蛋白117 g/L,血小板311×109/L,网织红细胞0.02。
A 21-month-old male patient was given nimesulide 50 mg twice daily for 15 h because of upper respiratory tract infection. 3 h after the first dose, children with convulsions, pale, yellow urine. The second 15 minutes after taking convulsions again, looking pale progressive, urine was dark brown. Laboratory examination after admission: C-reactive protein 79.0 mg / L; leucocyte count 35.6 × 109 / L, neutrophil count 27.1 × 109 / L, hemoglobin 33 g / L, platelet count 471 × 109 / L; thrombin time 17.2 s, prothrombin time 20.4 s, international standardization ratio 1.63, activated partial thromboplastin time 27.5 s, fibrinogen 2.95 g / L. To ECG, oxygen, intravenous dexamethasone, methylprednisolone and human immunoglobulin, intravenous infusion of sodium bicarbonate, infusion of washed red blood cells. Children with exacerbations, coma, limbs twitching, blood pressure 131/103 mm Hg (1 mm Hg = 0.133 kPa), heart rate 153 beats / min. To plasma exchange, anti-infective, immunosuppressive, hydration and nutritional support treatment, children with better condition. On the 8th day after admission, the blood routine examination was as follows: white blood cell count 7.0 × 109 / L, neutrophil count 5.3 × 109 / L, hemoglobin 117 g / L, platelet 311 × 109 / L and reticulocyte 0.02.