Yoshida Yasushi, Take Hitoshi, Kurabayashi Hitoshi, Tamura Kousei, Kubota Kazuo
Department of Medicine, Kusatsu Branch Hospital, Gunma University Hospital, Kusatsu, Gunma 377-1711, Japan.
J Med. 2002;33(1-4):3-8.
A 68-year old Japanese male with alcohol related rhabdomyolysis, hepatitis, and hematological disorders is presented. Biochemical data showed markedly elevated levels of serum hepatobiliary enzymes, lactate dehydrogenase and myoglobin, and decreased levels of serum sodium and phosphate. The serum creatine kinase level was approximately 40 times higher than the normal upper limit with 97% of MM fraction. Clinical manifestations of rhabdomyolysis, such as myalgia, muscle weakness and acute renal failure, were not recognized. Hematological examinations revealed mild neutropenia, lymphopenia, monocytopenia and thrombocytopenia but no anemia or macrocytosis. Initial treatment of an intravenous infusion of saline (30 mL/Kg body weight) and subsequent low sodium diet was successfully completed without severe complications. All the abnormal laboratory data were normalized within three weeks of his hospitalization. We suggest that hyponatremia and hypophosphatemia may be involved in the development of rhabdomyolysis, hepatitis and hematological disorders.
本文报告了一名68岁的日本男性，患有酒精相关性横纹肌溶解症、肝炎和血液系统疾病。生化数据显示血清肝胆酶、乳酸脱氢酶和肌红蛋白水平显著升高，血清钠和磷酸盐水平降低。血清肌酸激酶水平比正常上限高出约40倍，其中MM组分占97%。未发现横纹肌溶解症的临床表现，如肌痛、肌肉无力和急性肾衰竭。血液学检查显示轻度中性粒细胞减少、淋巴细胞减少、单核细胞减少和血小板减少，但无贫血或大细胞性贫血。最初通过静脉输注生理盐水（30 mL/千克体重）并随后采用低钠饮食进行治疗，成功完成且未出现严重并发症。住院三周内，所有异常实验室数据均恢复正常。我们认为低钠血症和低磷血症可能与横纹肌溶解症、肝炎和血液系统疾病的发生有关。
