由严重高钙血症和急性肾损伤引起的急性呼吸窘迫综合征:一个罕见的危及生命的并发症的病例报告和文献回顾。

Clinical Nephrology. Case Studies Pub Date : 2022-01-24 eCollection Date: 2022-01-01 DOI:10.5414/CNCS110464
Haresh Selvaskandan, Katherine Hull, Rachel Gregory, Daniel Pan, Thrasos Macriyiannis, Jenny Briggs, Catherine Richards, Catherine Mason, Jorge Jesus-Silva, Ricky Bell
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引用次数: 1

摘要

急性呼吸窘迫综合征(ARDS)是一种罕见且报道不足的高钙血症并发症,通常与急性肾损伤(AKI)合并出现。对病情的不熟悉不可避免地导致管理上的不确定性,从而导致致命的后果。然而,早期诊断能带来良好的预后。我们报告了一例40岁男性患者,他表现为严重的高钙血症和AKI,并因ARDS而迅速恶化,没有心源性肺水肿或液体超载的证据。感染筛查结果为阴性。尽管有创通气和持续静脉-静脉血液过滤,他还是死了。他的尸检显示广泛的转移性肺钙化和肺泡水肿。我们在文献中只发现了10例高钙血症引起的ARDS,只有2例患者存活。我们提供关于该主题的第一篇文献综述,以指导这种罕见但致命的并发症的管理,如果及早考虑,可以获得良好的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication.

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication.

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication.

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication.

Acute respiratory distress syndrome (ARDS) is a rare and under-reported complication of hypercalcemia, which often presents in conjunction with acute kidney injury (AKI). Unfamiliarity with the condition inevitably leads to management uncertainty, resulting in fatal outcomes. Early identification, however, confers a good prognosis. We report a case of a 40-year-old male who presented with severe hypercalcemia and AKI and rapidly deteriorated due to ARDS, with no evidence of cardiogenic pulmonary edema or fluid overload. Infection screens were negative. He died despite invasive ventilation and continuous venous-venous hemofiltration. His autopsy revealed extensive metastatic pulmonary calcifications and alveolar edema. We found only 10 other cases of hypercalcemia-induced ARDS in the literature, with only 2 patients surviving. We provide the first literature review on the subject to guide the management of this rare but fatal complication, which can be managed with good outcomes if considered early.

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