Use of Hemadsorption in a Case of Pediatric Toxic Shock Syndrome.
Berkes A, et al. Case Rep Crit Care. 2017.
Authors
Berkes A1, Szikszay E1, Kappelmayer J2, Kerényi A2, Szabó T1, Ujhelyi L3, Bari K4, Balla G1,5, Balla J3.
Author information
1Department of Pediatrics, University of Debrecen, Debrecen 4012, Hungary.
2Institute of Laboratory Medicine, University of Debrecen, Debrecen 4012, Hungary.
3Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen 4012, Hungary.
4Fresenius Medical Care, NephroCare University of Debrecen, Debrecen 4012, Hungary.
5HAS-UD Vascular Biology and Myocardial Pathophysiology Research Group, Hungarian Academy of Sciences, Debrecen 4012, Hungary.
Citation
Case Rep Crit Care. 2017;2017:3818407. doi: 10.1155/2017/3818407. Epub 2017 Jul 16.
Abstract
BACKGROUND: Toxic shock syndrome is a potentially fatal toxin-mediated disease. The role of toxins in this clinical entity made us hypothesize that extracorporeal blood purification with CytoSorb® could play a beneficial role in the clinical management of toxic shock syndrome. This case report describes the successful treatment of toxic shock syndrome using a combination of renal replacement therapy and hemadsorption in a pediatric patient.
CASE PRESENTATION: A 5-year-old girl with Down's syndrome presented with an inflamed area surrounding an insect bite, signs of systemic inflammation, and multiple organ failure. As previous attempts of immune modulation therapy were unsuccessful, renal replacement therapy was supplemented by the cytokine absorber CytoSorb. Treatment using this combination was associated with a rapid and significant stabilization in the hemodynamic situation and a decrease in inflammatory mediators within hours after the initiation of therapy. The application of CytoSorb therapy was simple and safe.
CONCLUSION: The use of extracorporeal blood purification with CytoSorb proved potentially beneficial by removing toxins and inflammatory mediators in this case and could therefore play a role in the clinical management of toxic shock syndrome. Whether CytoSorb has the potential to even positively influence mortality in patients with toxic shock syndrome still needs to be confirmed.
