在高风险患者中,林纳克洛提德沉的氧沙酸性病
Omar Ali1, Mauricio Monrroy2, Andrea Lightle3
1Department of Medicine.
Clinical nephrology. Case studies
|November 17, 2025
概括
利纳克洛提德是治疗便秘的刺激性肠综合征的药物,可在易受感染的个体中导致氧酸盐脏病 (ON). 这一案例凸显了在患有不明原因急性损伤 (AKI) 的患者中考虑药物史的重要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 氧酸盐病 (ON) 是一种罕见的病,由氧酸晶体沉积引起,导致急性损伤 (AKI) 或慢性病 (CKD).
- 导致ON的原因是初级或二级的,与林纳克洛提德一起,用于便秘性易怒肠综合征 (IBS-C),以前与ON无关.
- 导致ON的诱导因素包括吸收不良和脱水,这可能会增加肠道氧沙酸盐的吸收.
研究的目的:
- 报告一个独特的linaclotide沉氧酸盐脏病的病例.
- 突出林纳克洛提德在患有风险因素的患者中降低ON的潜在作用.
主要方法:
- 一个50岁的女性患者的病例报告,在开始治疗IBS-C后,她患上了严重的AKI.
- 临床表现包括疲劳,侧侧疼痛和白的便,肌素水平达到8.37 mg/dL.
- 通过脏活检证实了诊断,治疗涉及停用利纳克洛提德和支持性护理,导致脏恢复.
主要成果:
- 患者经历了严重的AKI,归因于林纳克洛提德的使用.
- 脏活检证实了氧酸盐脏病.
- 停用利纳克洛提德药物导致在两个月内出现显著的恢复.
结论:
- 在患有风险因素如吸收不良和脱水的患者中,林卡洛可能会通过增加肠道氧酸盐吸收和引起高氧化尿而导致ON的沉.
- 虽然没有直接的毒性,但利纳克洛提德可以加剧对ON的潜在敏感性.
- 在评估无法解释的AKI时,临床医生应考虑药物史和患者的风险因素,并考虑脏活检进行诊断.
相关概念视频
01:21Drugs for Treatment of Constipation-Predominant IBS
686
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
686
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
345
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
345
01:28Urinary Tract Calculi V: Nursing Management
259
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
259
01:17Drugs for Treatment of Diarrhea-Predominant IBS
612
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
612
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
254
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
254
01:30Urinary Tract Calculi III: Medical Management
188
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
188