Seorang Pria 21 Tahun dengan Urin Berwarna Gelap

Joseph Partogi Sibarani
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Abstract

First published by Strubing in 1882, Paroxysmal Nocturnal Hemoglobinuria (PNH) is a chronic acquired disorder characterized by the occurrence of intravascular hemolysis and hemoglobinuria which commonly occurs when patients sleep at night, caused by cellular abnormalities due to somatic mutations that cause intrinsic damage on the red blood cell membrane, making it more susceptible to complement lysis. The incidence of PNH varies greatly in various populations and is more common in Southeast Asia. In general, the incidence is estimated to be 1 -1.5 cases / million population. This case is more common in young adults, but can also be found in children and parents. In general the clinical picture of PNH includes symptoms of anemia, hemoglobinia, signs of bleeding, and gastrointestinal complaints. Diagnosis can be determined through blood, urine, bone marrow and cytogenetic examination. We reported the case of a 21-year-old man with complaints of pale face, easy fatigue and tea colored urine in the morning. After several laboratory tests and aspiration of the bone marrow, PNH diagnosis is made. Glucocorticoids used as therapy, and patients are discharged with clinical improvement.
一个21岁的男人在小便
阵发性夜间血红蛋白尿(Paroxysmal Nocturnal hemoxybinuria, PNH)由Strubing于1882年首次发表,是一种慢性获得性疾病,以发生血管内溶血和血红蛋白尿为特征,通常发生在患者夜间睡眠时,是由于体细胞突变导致红细胞膜内在损伤,使其更容易发生补体溶解而导致的细胞异常。PNH的发病率在不同人群中差异很大,在东南亚更为常见。一般情况下,发病率估计为每百万人1 -1.5例。这种情况在年轻人中更常见,但也可以在儿童和父母中发现。一般来说,PNH的临床表现包括贫血、血红蛋白减少、出血症状和胃肠道不适。诊断可通过血液、尿液、骨髓和细胞遗传学检查来确定。我们报告了一例21岁男性,自诉面部苍白,易疲劳,晨尿呈茶色。经过几次实验室检查和骨髓抽吸,诊断为PNH。使用糖皮质激素治疗,患者临床好转出院。
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