Kawakami Kazunobu, Abe Haruhiko, Harayama Nobuya, Nakashima Yasuhide
Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 1):105-7. doi: 10.1046/j.1460-9592.2003.00158.x.
A 71-year-old man, who was diagnosed with familial amyloidosis type I, was admitted for treatment of severe orthostatic hypotension associated with recurrent syncopal attacks. Head-up tilt testing demonstrated severe orthostatic hypotension (114/72 mmHg in the supine position and 62/34 mmHg in the upright position) with syncope or presyncope. Oral midodorine and fludrocortisone therapies failed to prevent his symptoms. After administration of subcutaneous erythropoietin, his blood pressure drop in the upright position was decreased and symptoms disappeared unassociated with improvement of anemia. Although previous reports have shown that the mechanism by which erythropoietin improves orthostatic hypotension is related to improvement in anemia, other mechanisms may also play a role.
一名71岁男性，被诊断为I型家族性淀粉样变性，因治疗与反复晕厥发作相关的严重直立性低血压而入院。头高位倾斜试验显示严重直立性低血压（仰卧位时为114/72 mmHg，直立位时为62/34 mmHg）伴有晕厥或晕厥前症状。口服米多君和氟氢可的松治疗未能预防其症状。皮下注射促红细胞生成素后，他直立位时的血压下降减轻，症状消失，且与贫血改善无关。尽管先前的报告表明促红细胞生成素改善直立性低血压的机制与贫血改善有关，但其他机制可能也起作用。
