Revista chilena de pediatría
versión impresa ISSN 0370-4106
DONOSO F, Alejandro; CAMACHO A, Jorge; CRUCES R, Pablo y KONG C, Jorge. Exchange transfusion for treatment of severe Pertussis. Rev. chil. pediatr. [online]. 2005, vol.76, n.6, pp. 599-604. ISSN 0370-4106. http://dx.doi.org/10.4067/S0370-41062005000600007.
Introduction: Infants with severe Pertussis infection in the first weeks of life show a high mortality risk. A poor prognosis is associated with high white blood cell count and severe pulmonary hypertension. The mechanisms of this severe complication are not completely understood; pulmonary vascular occlusion by leukocyte thrombi is reported. In the last years, new therapeutic options have been reported to reduce leukocyte mass, including the exchange transfusion. Case report: We report 2 infants under six month-old with severe Pertussis, presenting with cardiogenic shock, hypoxemia and pulmonary hypertension. During hospitalization in PICU, they presented hyperleukocytosis (45-106 x 109/l). Exchange transfusion (double volume) was performed; through the procedure the white blood cell decreased, the cardiopulmonary condition improved and the patients finally survived. Conclusion: In our experience, the clinical course and prognosis were different compared to the common evolution seen in infants with severe Pertussis infection. In the future, exchange transfusion could be considered as a therapy in severe Pertussis infection with hyperleukocytosis
Palabras llave : Bordetella pertussis; pulmonary hypertension; exchange transfusion; hyperleukocytosis.