一个伪巴特特/吉特曼综合征的病例,由长期滥用药引起,导致末期病
Atsushi Kondo1, Kunihiko Yoshiya2, Nana Sakakibara3
1Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan. akondo@med.kobe-u.ac.jp.
伪巴特特/吉特曼综合征 (PBS/PGS) 由药滥用可能导致严重的损伤. 早期诊断和干预对于预防末期病 (ESKD) 至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 伪巴特尔/吉特曼综合征 (PBS/PGS) 模仿吉特曼综合征 (GS),但是由药物或生活方式因素等次要原因引起的.
- 与GS相比,PBS/PGS与较高的功能障碍风险有关.
- 长期滥用药是一种潜在的,虽然不太常见的,导致PBS/PGS.
研究的目的:
- 报告第一个记录的PBS/PGS病例,导致慢性药滥用导致末期病 (ESKD).
- 突出早期诊断和治疗PBS/PGS的必要性,以防止不可逆转的损伤.
主要方法:
- 一个49岁女性的案例研究,她长期过度使用药.
- 临床评估包括监测电解质 (血清),功能 (血清肌素,EGFR) 和损伤标志物.
- 对病相关基因进行基因测试,以排除类似电解质失衡的原发性遗传原因.
主要成果:
- 患者患有持续的低血和与PBS/PGS一致的代谢性.
- 多年来观察到渐进性功能障碍,包括急性损伤 (AKI),需要血液透析.
- 尽管调整了药和补充剂的剂量,但患者最终进展到末期病 (ESKD),需要维持血液透析.
结论:
- 慢性药滥用可能导致伪巴特尔/吉特曼综合征,并最终进展到末期病.
- 及时识别潜在原因,如药滥用,并立即干预对于在PBS/PGS患者中保持功能至关重要.
- 这一案例强调了在对不明原因的电解质障碍和病的差异诊断中考虑药物和生活方式因素的重要性.
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