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乙醇和苯海拉明过量服用后发生横纹肌溶解症和急性肾衰竭。

Rhabdomyolysis and acute renal failure following an ethanol and diphenhydramine overdose.

作者信息

Haas Curtis E, Magram Yanina, Mishra Archana

机构信息

Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14260, USA.

出版信息

Ann Pharmacother. 2003 Apr;37(4):538-42. doi: 10.1345/aph.1C241.

Abstract

OBJECTIVE

To report a case of nontraumatic rhabdomyolysis complicated by oliguric, acute renal failure following an intentional overdose of ethanol and diphenhydramine.

CASE SUMMARY

A 21-year-old white man was admitted through the emergency department following an intentional overdose of ethanol and diphenhydramine. The patient subsequently developed acute renal failure, and a diagnosis of nontraumatic rhabdomyolysis was made. With the absence of other common causes in this case, the rhabdomyolysis was believed to be due to the combined ethanol and diphenhydramine overdose.

DISCUSSION

Rhabdomyolysis is a severe and life-threatening syndrome caused by various insults to skeletal muscle, including drug-induced injury. Early detection and institution of effective treatments are essential to minimizing the complications of this syndrome. A delay in establishing the diagnosis in this case likely contributed to the severity of the renal failure.

CONCLUSIONS

Nontraumatic rhabdomyolysis is an uncommon adverse outcome of drug and toxin ingestion. Due to the potential severity of the complications of this syndrome and the importance of early recognition and treatment to prevent renal failure, clinicians should have a high index of suspicion for rhabdomyolysis following overdoses that involve alcohol or antihistamines.

摘要

目的

报告一例非创伤性横纹肌溶解症病例,该病例因故意过量服用乙醇和苯海拉明后并发少尿型急性肾衰竭。

病例摘要

一名21岁白人男性因故意过量服用乙醇和苯海拉明通过急诊科入院。患者随后出现急性肾衰竭,并诊断为非创伤性横纹肌溶解症。鉴于该病例中不存在其他常见病因,横纹肌溶解症被认为是由乙醇和苯海拉明过量服用共同导致的。

讨论

横纹肌溶解症是一种由多种对骨骼肌的损伤引起的严重且危及生命的综合征,包括药物性损伤。早期检测并采取有效治疗对于将该综合征的并发症降至最低至关重要。本病例中诊断的延迟可能导致了肾衰竭的严重程度。

结论

非创伤性横纹肌溶解症是药物和毒素摄入罕见的不良后果。鉴于该综合征并发症的潜在严重性以及早期识别和治疗以预防肾衰竭的重要性,临床医生对于涉及酒精或抗组胺药的过量用药后发生横纹肌溶解症应保持高度怀疑。

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