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高剂量甲状腺应用后的急性损伤 - 病例报告
Petya Markova1, Mariya Spasova1, Neofit Spasov1
1Medical University of Plovdiv, Plovdiv, Bulgaria.
Folia medica
|October 30, 2025
概括
高剂量的甲状腺素可以在患有癌症的儿童中引起损伤. 这项案例研究表明,在急性损伤后,成功地重新注射甲状腺,证明了其在骨髓瘤治疗中的安全性和有效性.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 高剂量甲基酸盐 (HDMTX) 对于治疗儿童癌症,如骨髓瘤至关重要.
- 毒性是HDMTX的重要并发症,发生在1.8%~36%的病例中.
- 目前的治疗包括补水,尿液化和抗药疗法,但损伤仍然发生.
研究的目的:
- 调查急性损伤 (AKI) 后重新使用HDMTX的安全性和可行性.
- 评估与HDMTX诱导的毒性相关的长期预后和风险因素.
- 呈现一个成功的HDMTX重新挑战的临床案例,在一个儿科骨髓瘤患者.
主要方法:
- 一个13岁的女性患有骨肉瘤的病例报告,在HDMTX后发展了4级AKI.
- 由于严重的毒性,开始进行置换疗法.
- 随后的HDMTX疗程是在恢复后逐渐增加剂量 (高达20g) 的.
主要成果:
- 患者经历了严重的AKI,在初始HDMTX后需要脏替代疗法.
- 接下来的四个HDMTX疗程是以升级剂量 (3g/m2,8g/m2,12g/m2,共20g) 进行的.
- 所有的再挑战疗程都能很好地容忍及时消除药物,没有证据表明有复发性毒性.
结论:
- 在AKI后重新服用HDMTX在儿科骨髓瘤患者中是可行的和安全的.
- 仔细监测和剂量升级可以允许持续有效的癌症治疗.
- 当HDMTX对治疗成功至关重要时,这种方法可能是一个可行的选择.
关键词:
甲基酸甲基酸毒性急性损伤 损伤
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