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当两个综合征碰撞时:在一个病人身上管理Fanconi和再养综合征
Francisco J Gallegos Koyner1, Nelson Barrera1, Prakriti Subedi1
1Internal Medicine, St. Barnabas Hospital Health System, New York City, USA.
Cureus
|February 12, 2024
概括
重新养综合征会导致严重的电解质失衡,特别是低度血. 这一案例突显出一种罕见的Fanconi综合征并发症,该并发症来自于tenofovir alafenamide (TAF) 疗法,在艾滋病患者中因人工养而恶化.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 重新养综合征是营养不良患者人工再养的潜在致命并发症,其特征是电解质转移,特别是低度血.
- 方科尼综合征是一种近道管的疾病,伴有管酸性,酸性,糖性,氨基酸性和蛋白质性,通常是由诺福维尔等药物引起的.
- 诺福维尔阿拉芬胺 (TAF) 是一种用于治疗艾滋病毒的抗逆转录病毒药物,很少有人报告引起Fanconi综合征.
研究的目的:
- 在艾滋病毒阳性患者中报告一种罕见的Fanconi综合征与tenofovir alafenamide (TAF) 相关的病例.
- 为了说明TAF诱导的Fanconi综合征的背景下,人工再养可能会加剧电解质异常.
- 强调在接受TAF的患者中监测电解质的重要性,特别是那些接受营养支持的患者.
主要方法:
- 病例报告介绍了一个患有艾滋病和多重物质滥用症的成年患者,因肺炎而入院.
- 启动抗逆转录病毒疗法 (ART),包括特诺福维尔阿拉芬胺 (TAF) 肺炎后治疗.
- 在人工再养期间观察严重的低酸血症和其他电解质失衡,从而诊断出Fanconi综合征.
主要成果:
- 患者在开始TAF并接受人工再养后出现了严重的低酸血和其他电解质障碍.
- 临床表现和实验室发现与Fanconi综合征一致,这是TAF的罕见并发症.
- 患者经历了严重的并发症,最终导致死亡,这凸显了这种罕见的不良事件的严重性.
结论:
- 这一案例突显出一种罕见但严重的复发症,即二甲胺 (TAF) 诱导的Fanconi综合征.
- 人工再可以显著恶化敏感患者的电解质异常,导致不良结果.
- 在TAF治疗的患者中,对电解质失衡的警监测至关重要,特别是在开始营养支持时.
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