Miyabayashi Hiroshi, Yamamori Hiroyuki, Nishimura Atsushi, Kohira Ryutaro, Fujita Yukihiko, Okubo Osami, Harada Kensuke
Department of Pediatrics, Nihon University School of Medicine, Tokyo.
No To Hattatsu. 2002 Nov;34(6):517-22.
We report a case of severe rhabdomyolysis associated with Salmonella encephalopathy. A 3-year-old girl was admitted to our hospital because of status convulsives and unconsciousness. She was diagnosed as having Salmonella encephalopathy with rhabdmyolysis, and was treated by mild hypothermia and mechanical ventilation. Five days later she developed anuria with increased serum levels of myoglobin, CK and creatinine. And the diagnosis of acute renal failure was made. Peritoneal dialysis was begun from 6 days after admission. Hyperinfusion, the usual therapy of rhabdomyolysis, was not performed. She survived showing gradual improvement of renal function and consciousness. In a case of rhabdomyolysis complicating a neurologic disorder, a well-known poor prognostic factor, priority should be given to brain protection rather than to symptomatic treatment of rhabdomyolysis.
我们报告一例与沙门氏菌性脑病相关的严重横纹肌溶解症。一名3岁女孩因惊厥持续状态和昏迷入住我院。她被诊断为患有沙门氏菌性脑病合并横纹肌溶解症，并接受了亚低温治疗和机械通气。五天后，她出现无尿，血清肌红蛋白、肌酸激酶和肌酐水平升高。于是诊断为急性肾衰竭。入院6天后开始进行腹膜透析。未采用横纹肌溶解症的常规治疗方法——大量补液。她最终存活下来，肾功能和意识逐渐改善。在横纹肌溶解症并发神经系统疾病（一个众所周知的预后不良因素）的病例中，应优先考虑脑保护，而非横纹肌溶解症的对症治疗。
