Stanley de Almeida Araújo, Isabela Stefanon, David Campos Wanderley, Rodrigo Zamprogna, Rafaele Zampier, Ana Cristina Simões-E-Silva
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引用次数: 0
摘要
我们旨在描述一例罕见的急性肾损伤(AKI)病例。我们描述了一名先前健康的 24 岁男性出现急性肾损伤并伴有神经系统和呼吸系统症状的病例。他最初因恶心、呕吐、视力模糊和尿量减少入院。大约一周后,患者病情恶化。实验室检查显示,患者体内含氮废物水平过高、低钠血症、代谢性酸中毒(阴离子间隙增大)、蛋白尿和血尿。患者出现麻痹、抽搐、呼吸改变和意识改变。最初的快速进展性肾小球肾炎诊断假设没有得到证实。深入调查后发现,该病例可能是二甘醇(DEG)蓄意外源性中毒所致。肾活检结果提示中毒引起的肾中毒,证实了这一怀疑。尽管采取了各种治疗措施,患者还是因肺部并发症而死亡。本病例报告表明,有必要将 DEG 中毒视为 AKI 的病因之一,尤其是在有神经系统症状的患者中。实验室和组织病理学分析对诊断至关重要。
A case of suicide secondary to diethylene glycol intentional ingestion.
We aimed to describe a case of acute kidney injury (AKI) with an uncommon case. We described a previously health 24 years old male that presented acute kidney injury associated with neurological and respiratory symptoms. He was initially admitted at the hospital with nausea, vomiting, blurred vision, and reduced urine output. The patient's condition got worse approximately in one week. Laboratory tests revealed high levels of nitrogenous waste, hyponatremia, metabolic acidosis with an increased anion gap, and the presence of proteinuria and hematuria. The patient experienced paresthesia, seizures, respiratory alterations, and altered consciousness. The initial diagnostic hypothesis of rapidly progressive glomerulonephritis was not confirmed. A deeper investigation of the case exposed that it could have occurred an intentional exogenous poisoning with diethylene glycol (DEG). Renal biopsy unveil findings suggestive of poison-induced nephrotoxicity, which corroborated the suspicion. Despite therapeutic efforts, the patient died due to pulmonary complications. This case report shows the need to consider DEG poisoning as a etiology of AKI, especially in patients with neurological symptoms. Laboratory and histopathological analysis were crucial for the diagnosis.
期刊介绍:
Forensic Science, Medicine and Pathology encompasses all aspects of modern day forensics, equally applying to children or adults, either living or the deceased. This includes forensic science, medicine, nursing, and pathology, as well as toxicology, human identification, mass disasters/mass war graves, profiling, imaging, policing, wound assessment, sexual assault, anthropology, archeology, forensic search, entomology, botany, biology, veterinary pathology, and DNA. Forensic Science, Medicine, and Pathology presents a balance of forensic research and reviews from around the world to reflect modern advances through peer-reviewed papers, short communications, meeting proceedings and case reports.