酸作为铁性碳酸-马尔托斯诱导的低酸血症的治疗策略
Freny Patel1, Prince Modi1, Bosky Modi2
1Internal Medicine, Pramukhswami Medical College, Karamsad, IND.
Cureus
|December 9, 2025
概括
静脉注射铁性碳酸糖 (FCM) 可以导致严重的低酸血症在患有蛋白质损失肠道病变的患者. 口服卡尔西醇有效地使酸盐和水平正常化,突出了对这种铁引起的并发症的认识的需要.
科学领域:
- 内分泌学 在内分泌学.
- 胃肠病学 胃肠病学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 异形性蛋白质丧失肠道病 (IPLE) 是一种罕见的疾病,其特点是胃肠道中过度丧失蛋白质.
- 患有IPLE的患者通常需要营养支持,例如全方位肠道营养 (TPN).
- 贫血是IPLE患者常见的并发症,经常用静脉注射铁制剂治疗.
研究的目的:
- 在TPN的IPLE老年患者中,在给铁性碳酸盐盐糖 (FCM) 后报告一个严重的低酸血症病例.
- 要突出临床表现和管理FCM诱导的低酸血症,是"6H综合征"的一个组成部分.
- 强调在脆弱患者群体中识别和管理与静脉注射铁疗法相关的电解质障碍的重要性.
主要方法:
- 一个83岁的男性在TPN上患有IPLE的案例报告.
- 详细的临床过程,包括在静脉注射铁碳酸盐 (FCM) 输注前和后的实验室发现.
- 评估电解质水平,包括酸盐,,维生素D代谢物和纤维细胞生长因子23 (FGF23).
- 对酸盐补充剂的治疗反应和随后开始口服酸的评估.
主要成果:
- 患者在FCM输液后出现严重,持续的低酸血和低血症.
- 实验室检测结果包括二次性甲状腺功能障碍,抑制的1,25-二氧维生素D,明显升高的FGF23.
- 低酸盐血症是对常规酸盐补充剂耐药的.
- 开始口服酸导致和酸盐水平快速正常化,实现长期稳定.
结论:
- 铁碳酸 (FCM) 可以导致严重的低酸血症在患有蛋白质损失肠病和营养不良的患者.
- 由FCM诱导的低酸血与特征性的荷尔蒙和电解质异常有关,与"6H综合征"一致.
- 口服酸是一种有效的治疗方法,可以使这种情况的酸盐和水平正常化,使得在没有进一步的静脉铁暴露的情况下继续管理.
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