[血浆渗漏导致的低血压和全身水肿:病例报告]。

Q4 Medicine
Stefano Gatto, Alessio Di Maria, Cristina Bonesso, Mario Vergone, Elena Momesso, Laura Maria Scichilone, Fabio Fabbian
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引用次数: 0

摘要

全身性水肿在日常临床实践中很常见,通常是由心脏、肝脏和肾脏疾病引起的。另一方面,与低血压、血液浓缩和低白蛋白血症相关的液体外渗引起的水肿是一种罕见的临床疾病。我们报告了一例 61 岁男性患者的病例,他因 Sars-Cov-2 感染先后 3 次出现内皮通透性改变,且病情越来越严重。在最后一次发作期间,他被送进了重症监护室,被诊断出患有单克隆丙种球蛋白病,并出现了急性肾损伤,需要持续接受肾脏替代治疗。诊断出全身毛细血管渗漏综合征或克拉克森病,并确认了该病的三个阶段,即前驱期、急性休克期和恢复期。患者康复后,肾功能恢复到正常值。肾脏病学家应注意血浆渗漏综合征,由于其并发症如急性肾损伤、隔室综合征和神经病变、横纹肌溶解症、心肌水肿、心包-胸腔-腹腔积液、深静脉血栓和急性肺水肿的风险,因此很难对其进行处理,尤其是输液。Sars-Cov-2 感染似乎增加了这种罕见疾病的发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Hypotension and Generalized Edema Due to Plasma Leakage: A Case Report].

Generalized edema is commonly encountered in everyday clinical practice, usually due to heart, liver and renal disease. On the other hand, edema related to fluid extravasation associated with hypotension, hemoconcentration and hypalbuminemia is a rare clinical disorder. We present a case of a 61-year-old man with 3 subsequent endothelium permeability alteration episodes with increasing severity related to Sars-Cov-2 infection. During the last episode he was admitted to the intensive care unit, a monoclonal gammopathy was diagnosed and acute kidney injury requiring continuous renal replacement therapy developed. Systemic capillary leak syndrome or Cklarkson's disease was diagnosed, and the three phases of the condition were recognized, i.e. the prodromal phase, the acute shock phase and the recovery phase. The patients recovered and his kidney function returned to normal values. Nephrologists should be aware of plasma leakage syndromes being their management, especially fluid infusion, difficult due to the risk of complications such as acute kidney injury, compartment syndrome and neuropathy, rhabdomyolysis, myocardial edema, pericardial-pleural-abdominal effusion, deep vein thrombosis and acute pulmonary edema. Sars-Cov-2 infection appears to have increased the frequency of this rare disease.

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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
62
期刊介绍: Il Giornale Italiano di Nefrologia (GIN) è la rivista di educazione continua della Società Italiana di Nefrologia SIN ed è pubblicato bimestralmente. E" il più autorevole organo di informazione nefrologia disponibile a livello nazionale. Il giornale Italiano di Nefrologia offre la più aggiornata informazione medico-scientifica rivolta al nefrologo sotto forma di rassegne, casi clinici e articoli finalizzati all’Educazione Continua in Medicina, oltre ai notiziari ed agli atti dei congressi di questa prestigiosa Società Scientifica
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