グレイ症候群
WordNet
- a project of personal concern to someone; "this project is his baby"
- a very young mammal; "baby rabbits"
- a very young child (birth to 1 year) who has not yet begun to walk or talk; "the baby began to cry again"; "she held the baby in her arms"; "it sounds simple, but when you have your own baby it is all so different" (同)babe, infant
- (slang) sometimes used as a term of address for attractive young women (同)babe, sister
- an unborn child; a human fetus; "I felt healthy and very feminine carrying the baby"; "it was great to feel my baby moving about inside"
- the youngest member of a group (not necessarily young); "the baby of the family"; "the baby of the Supreme Court"
- United States botanist who specialized in North American flora and who was an early supporter of Darwins theories of evolution (1810-1888) (同)Asa Gray
- English radiobiologist in whose honor the gray (the SI unit of energy for the absorbed dose of radiation) was named (1905-1965) (同)Louis Harold Gray
- American navigator who twice circumnavigated the globe and who discovered the Columbia River (1755-1806) (同)Robert Gray
- English poet best known for his elegy written in a country churchyard (1716-1771) (同)Thomas Gray
- the SI unit of energy absorbed from ionizing radiation; equal to the absorption of one joule of radiation energy by one kilogram of matter; one gray equals 100 rad (同)Gy
- a neutral achromatic color midway between white and black (同)grayness, grey, greyness
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
PrepTutorEJDIC
- 『赤ん坊,赤ちゃん』 / (家族・グループの中で)いちばん年少の人,最年少者 / 赤ん坊みたいな人 / (また『babe』)《米俗》《特に若い女の子への呼びかけた用いて》かわいこちゃん / 赤ん坊の[ような],赤ちゃん用の / 《話》…'を'赤ちゃんのように扱う,甘やかす
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/01/22 00:50:44」(JST)
[Wiki en表示]
Not to be confused with Bronze baby syndrome.
Gray baby syndrome |
Classification and external resources |
Specialty |
pediatrics |
ICD-10 |
P93 |
ICD-9-CM |
779.4 |
MedlinePlus |
007049 |
Gray baby syndrome (also termed Gray or Grey syndrome) is a rare but serious side effect that occurs in newborn infants (especially premature babies) following the intravenous administration of the antimicrobial chloramphenicol.[1]
Contents
- 1 Signs and symptoms
- 2 Pathophysiology
- 3 Prevention
- 4 Treatment
- 5 References
- 6 Further reading
Signs and symptoms
Toxic levels of chloramphenicol after 2–9 days result in:
- Vomiting
- Ashen gray color of the skin
- Limp body tone
- Hypotension (low blood pressure)
- Cyanosis blue discolouration of lips and skin.
- Hypothermia
- Cardiovascular collapse
Pathophysiology
Two pathophysiologic mechanisms are thought to play a role in the development of gray baby syndrome after exposure to the anti-microbial drug chloramphenicol. This condition is due to a lack of glucuronidation reactions occurring in the baby, thus leading to an accumulation of toxic chloramphenicol metabolites. :[2]
- The UDP-glucuronyl transferase enzyme system of infants, especially premature infants, is immature and incapable of metabolizing the excessive drug load.
- Insufficient renal excretion of the unconjugated drug.
Due to these two reasons the chloramphenicol level in blood is increased, at higher concentration chloramphenicol blocks electron transport in the liver, myocardium, and skeletal muscles, resulting the above symptoms.
Prevention
The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels,[3][4][5] or alternatively, third generation cephalosporins can be effectively substituted for the drug, without the associated toxicity.[6]
Treatment
Chloramphenicol therapy should be stopped immediately. Exchange transfusion may be required to remove the drug. Sometimes, phenobarbital (UGT induction) is used.
References
- ^ McIntyre J, Choonara I (2004). "Drug toxicity in the neonate.". Biol Neonate 86 (4): 218–21. doi:10.1159/000079656. PMID 15249753.
- ^ Brunton, Laurence L.; Lazo, John S.; Parker, Keith, eds. (2005). "Chapter 46. Protein Synthesis Inhibitors and Miscellaneous Antibacterial Agents". Goodman & Gilman's The Pharmacological Basis of Therapeutics (11th ed.). New York: McGraw-Hill. ISBN 0-07-142280-3.
- ^ Feder H (1986). "Chloramphenicol: what we have learned in the last decade.". South Med J 79 (9): 1129–34. doi:10.1097/00007611-198609000-00022. PMID 3529436.
- ^ Mulhall A, de Louvois J, Hurley R (1 January 1983). "Chloramphenicol toxicity in neonates: its incidence and prevention". British medical journal (Clinical research ed.) 287 (6403): 1424–7. doi:10.1136/bmj.287.6403.1424. PMC 1549666. PMID 6416440.
- ^ Forster J, Hufschmidt C, Niederhoff H, Künzer W (1985). "[Need for the determination of chloramphenicol levels in the treatment of bacterial-purulent meningitis with chloramphenicol succinate in infants and small children]". Monatsschr Kinderheilkd 133 (4): 209–13. PMID 4000136.
- ^ Aggarwal, R; Sarkar, N; Deorari, AK; Paul, VK (Dec 2001). "Sepsis in the newborn" (PDF). Indian journal of pediatrics 68 (12): 1143–1147. doi:10.1007/BF02722932. PMID 11838570.
Further reading
- Krasinski, K; Perkin, R; Rutledge, J (1 September 1982). "Gray Baby Syndrome Revisited". Clinical Pediatrics 21 (9): 571–572. doi:10.1177/000992288202100910. PMID 7105617.
- Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL, ed. (2009). "Ch.248. Antibacterial therapeutic agents". Feigin & Cherry's textbook of pediatric infectious diseases (6th ed.). Philadelphia, PA: Saunders/Elsevier. ISBN 1416040447.
Certain conditions originating in the perinatal period / fetal disease (P, 760–779)
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Maternal factors and
complications of pregnancy,
labour and delivery |
placenta: |
- Placenta praevia
- Placental insufficiency
- Twin-to-twin transfusion syndrome
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chorion/amnion: |
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umbilical cord: |
- Umbilical cord prolapse
- Nuchal cord
- Single umbilical artery
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|
|
Length of gestation
and fetal growth |
- Small for gestational age/Large for gestational age
- Preterm birth/Postmature birth
- Intrauterine growth restriction
|
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Birth trauma |
- scalp
- Cephalhematoma
- Chignon
- Caput succedaneum
- Subgaleal hemorrhage
- Brachial plexus lesion
- Erb's palsy
- Klumpke paralysis
|
|
By system |
Respiratory |
- Intrauterine hypoxia
- Infant respiratory distress syndrome
- Transient tachypnea of the newborn
- Meconium aspiration syndrome
- pleural disease
- Pneumothorax
- Pneumomediastinum
- Wilson–Mikity syndrome
- Bronchopulmonary dysplasia
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Cardiovascular |
- Pneumopericardium
- Persistent fetal circulation
|
|
Haemorrhagic and
hematologic disease |
- Vitamin K deficiency
- Haemorrhagic disease of the newborn
- HDN
- ABO
- Anti-Kell
- Rh c
- Rh D
- Rh E
- Hydrops fetalis
- Hyperbilirubinemia
- Kernicterus
- Neonatal jaundice
- Velamentous cord insertion
- Intraventricular hemorrhage
- Germinal matrix hemorrhage
- Anemia of prematurity
|
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Digestive |
- Ileus
- Necrotizing enterocolitis
- Meconium peritonitis
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Integument and
thermoregulation |
- Erythema toxicum
- Sclerema neonatorum
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Nervous system |
- Periventricular leukomalacia
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Musculoskeletal |
- Gray baby syndrome
- muscle tone
- Congenital hypertonia
- Congenital hypotonia
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Infectious |
- Vertically transmitted infection
- Neonatal infection
- Congenital rubella syndrome
- Neonatal herpes simplex
- Mycoplasma hominis infection
- Ureaplasma urealyticum infection
- Omphalitis
- Neonatal sepsis
- Group B streptococcal infection
- Neonatal conjunctivitis
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Other |
- Perinatal mortality
- Stillbirth
- Infant mortality
- Neonatal withdrawal
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Index of developmental medicine
|
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Description |
- Embryology
- Cell lines
- Stem cells
- endoderm
- mesoderm
- ectoderm
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Disease |
- Due to toxins
- Syndromes
- Chromosomal
- Neonate
- Twins
|
Index of obstetrics
|
|
Description |
- Pregnancy
- Development
- Anatomy
|
|
Disease |
- Pregnancy and childbirth
- Placenta and neonate
- Infections
- Symptoms and signs
|
|
Treatment |
- Procedures
- Drugs
- oxytocins
- labor repressants
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|
UpToDate Contents
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English Journal
- The integrative role of the sigh in psychology, physiology, pathology, and neurobiology.
- Ramirez JM.
- Progress in brain research.Prog Brain Res.2014;209:91-129. doi: 10.1016/B978-0-444-63274-6.00006-0.
- "Sighs, tears, grief, distress" expresses Johann Sebastian Bach in a musical example for the relationship between sighs and deep emotions. This review explores the neurobiological basis of the sigh and its relationship with psychology, physiology, and pathology. Sighs monitor changes in brain states
- PMID 24746045
- Mutations in FBXL4, encoding a mitochondrial protein, cause early-onset mitochondrial encephalomyopathy.
- Gai X1, Ghezzi D, Johnson MA, Biagosch CA, Shamseldin HE, Haack TB, Reyes A, Tsukikawa M, Sheldon CA, Srinivasan S, Gorza M, Kremer LS, Wieland T, Strom TM, Polyak E, Place E, Consugar M, Ostrovsky J, Vidoni S, Robinson AJ, Wong LJ, Sondheimer N, Salih MA, Al-Jishi E, Raab CP, Bean C, Furlan F, Parini R, Lamperti C, Mayr JA, Konstantopoulou V, Huemer M, Pierce EA, Meitinger T, Freisinger P, Sperl W, Prokisch H, Alkuraya FS, Falk MJ, Zeviani M.
- American journal of human genetics.Am J Hum Genet.2013 Sep 5;93(3):482-95. doi: 10.1016/j.ajhg.2013.07.016. Epub 2013 Aug 29.
- Whole-exome sequencing and autozygosity mapping studies, independently performed in subjects with defective combined mitochondrial OXPHOS-enzyme deficiencies, identified a total of nine disease-segregating FBXL4 mutations in seven unrelated mitochondrial disease families, composed of six singletons
- PMID 23993194
- Dravet syndrome: new potential genetic modifiers, imaging abnormalities, and ictal findings.
- Gaily E1, Anttonen AK, Valanne L, Liukkonen E, Träskelin AL, Polvi A, Lommi M, Muona M, Eriksson K, Lehesjoki AE.
- Epilepsia.Epilepsia.2013 Sep;54(9):1577-85. doi: 10.1111/epi.12256. Epub 2013 Jun 28.
- PURPOSE: Dravet syndrome is an autosomal dominant epileptic encephalopathy of childhood, which is caused mainly by SCN1A and PCHD19 mutations. Although Dravet syndrome is well recognized, the causes of acute encephalopathy are still elusive, and reported data on ictal electroencephalography (EEG) an
- PMID 23808377
Related Links
- Also called gray-baby syndrome. gray syndrome, a toxic condition in neonates, especially premature infants, caused by a reaction to chloramphenicol. Because the body's mechanisms for detoxification and excretion of drugs are . ...
- gray baby syndrome. See gray syndrome. Gray Syndrome A condition that may occur when chloramphenicol levels exceed 70 µg/mL; premature infants are most susceptible, given their limited capacity to glucuronidate and excrete ...
- Gray baby syndrome information including symptoms, diagnosis, misdiagnosis, treatment, causes, patient stories, videos, forums, prevention, and prognosis. ... Gray baby syndrome: Introduction Gray baby syndrome: A side effect ...
★リンクテーブル★
[★]
- 英
- chloramphenicol, CP
- 化
- コハク酸クロラムフェニコールナトリウム
- 商
- クロロマイセチンサクシネート、クロロマイセチン Chloromycetin、(クロラムフェニコール、コリスチンメタンスルホン酸ナトリウム)オフサロン、コリマイ、コリナコール。(クロラムフェニコール、フラジオマイシン、プレドニゾロン)クロマイ、ハイセチンP。ハイセチン
- 関
- 抗菌薬。化膿性疾患用剤
特徴
- a broad-spectrum bacteriostatic agent ← クロラムフェニコール & テトラサイクリン
- 50SリボソームのA siteに結合してpeptide bond formationを妨げる。
- 静菌的に作用する。
- 毒性が強いので、激しい感染症のケース、または局所薬として用いられる。
作用機序
- リボソームの50Sサブユニットに作用
- inhibits 50S peptidyltransferase
適応
- 副作用のためUSでの使用は稀
- meningitis (Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae).
禁忌
- 肝機能や腎機能が未熟なため
副作用
[★]
- 英
- gray syndrome, gray baby syndrome
- 同
- 灰白症候群
- 関
- クロラムフェニコール
- 新生児へのクロラムフェニコール投与は、肝機能が未熟であることからクロラムフェニコールの血中濃度が高まり、急性末梢循環不全を来す。この結果として皮膚の色が灰白色となる。
- いまどき、クロラムフェニコールを経口で使うことはあまりないけどね
[★]
- 関
- infant、infantile、newborn infant、suckling、sucklings
[★]
- 関
- grey、griseus、Gy
[★]