胆固醇栓塞性病:一个大型医疗保健系统的经验
Swachi Jain1, Abhishek Nimkar2, Susana Hong2
1Departments of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
International journal of surgical pathology
|July 21, 2024
概括
胆固醇栓塞性病是罕见的,但致命的,即使没有最近的程序. 通过仔细的显微镜检查活检的早期检测对于改善患者的治疗结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 病理学 病理学 病理学
- 心血管医学 心血管医学
背景情况:
- 胆固醇栓塞性病 (CERD) 是一种罕见的疾病.
- 它通常与动脉样硬化疾病和诸如血管内手术之类的阴性病因有关.
- 了解其临床病理特征对于诊断和管理至关重要.
研究的目的:
- 确定胆固醇栓塞性病的临床病理特征.
- 审查关于CERD的文献.
- 确定与CERD及其成果相关的因素.
主要方法:
- 在2017年7月至2022年10月期间被诊断患有CERD的10名患者的回顾性病例系列.
- 临床数据的分析,包括功能 (肌素水平),呈现症状 (急性损伤,蛋白尿) 和实验室发现 (血清乙蛋白).
- 用光显微镜 (H&E,特殊染料) 和电子显微镜检查脏活检的组织病理学检查,以确定胆固醇裂.
主要成果:
- 在3087个活检中,CERD患病率为0.32% (10例).
- 四名患者最近进行了血管内手术;四名患者有远程病史.
- 七名患者呈现急性损伤;观察到肌素水平升高.
- 八名患者的血清乙氨基酸水平升高;4个月内死亡率为30%.
- 胆固醇裂,表明动脉样硬化栓塞,在90%的光显微镜和40%的电子显微镜活检中被发现.
结论:
- 虽然CERD可能是缓慢的,特别是在没有最近手术的患者中,但死亡率很高.
- 血清中乙氨基的升高和急性损伤是常见的临床表现.
- 对脏活检进行彻底的显微镜检查,包括所有水平和半薄部分,对于准确的诊断至关重要.
相关概念视频
01:26Endoscopic Procedures V: ERCP
161
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
161
01:29Chronic Pancreatitis II: Collaborative Care
82
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
82
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
621
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
621
01:17Factors Affecting Renal Clearance: Renal Impairment
72
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
72
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
668
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
668