Aragane Kazumi, Kitaura Nayuki, Kitada Osamu, Nakamura Hitoshi, Miyata Shigeru, Jin Shouko, Nagasawa Namiko, Takenaka Noriko, Nakagomi Takayuki, Kuribayashi Kouzou, Matsuyama Tomohiro, Sugita Minoru
Department of Internal Medicine, Division of Respiratory Disease, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 Dec;40(12):941-4.
A 53-yr-old man with a history of chronic renal failure was admitted to the hospital of Hyogo College of Medicine on March 24th, 1999, because of severe continuous hemoptysis. On February 14th, 1999, the patient had undergone a cadaveric kidney transplantation in the urology department of another hospital. He did not experience any immunological reactions due to tissue rejection. On admission, subcutaneous bleeding at the site of an injection received 1 month before was noticed on his left arm. Petecheae of the extremities and a conjunctival hemorrhage were also noted. However, coagulation and fibrinolysis tests were essentially normal. These findings indicated that the hemorrhages were due to vessel weakness. Scurvy was diagnosed since his serum vitamin C was extremely low (0.2 microgram/ml). The patient was given ascorbic acid (1 g/day), and his condition improved dramatically. Ten years ago, the patient had had renal failure, which had been treated with chronic maintenance dialysis and dietary restriction. It has been postulated that a diet lacking in vitamin C or the steroid treatment he received after kidney transplantation may have induced the scurvy.
一名53岁的慢性肾衰竭男性患者于1999年3月24日因严重持续性咯血入住兵库医科大学医院。1999年2月14日，该患者在另一家医院的泌尿外科接受了尸体肾移植。他没有因组织排斥而出现任何免疫反应。入院时，发现其左臂有1个月前注射部位的皮下出血。还注意到四肢有瘀点和结膜出血。然而，凝血和纤溶试验基本正常。这些发现表明出血是由于血管脆弱所致。由于其血清维生素C极低（0.2微克/毫升），故诊断为坏血病。给予患者维生素C（1克/天），其病情显著改善。10年前，该患者患有肾衰竭，一直通过慢性维持性透析和饮食限制进行治疗。据推测，缺乏维生素C的饮食或肾移植后接受的类固醇治疗可能诱发了坏血病。
