Hatakeyama A, Fujinaga H, Togo T, Tamura T, Ozawa K, Shoji T, Sasaoka T
Department of Internal Medicine, Yokosuka Kyosai Hospital, Japan.
Adv Perit Dial. 1992;8:116-9.
Pseudotumor of the craniocervical junction and destructive spondyloarthropathy (DSA) are the most serious forms of dialysis amyloidosis (DAA). Pain and paralysis due to these lesions significantly impair activity of a patients' daily life (ADL). CAPD improved ADL of a 54 year-old male patient complicated with various forms of DAA after 17 years of hemodialysis (HD) treatment. He was first diagnosed as having carpal tunnel syndrome 12 years after initiation of hemodialysis followed by dialysis shoulders(12 years), trigger fingers(12 years), bone cysts(15 years), tendon ruptures(17 years), DSA and a pseudotumor of the craniocervical junction(17 years). Magnetic resonance imaging (MRI) taken in May 1989 revealed a pseudotumor of the craniocervical junction, which was 30 mm in diameter, located in front of partially destroyed C1 and C2. Neck pain and muscle weakness rendered him bed ridden. Six months after switching to CAPD with administration of prednisolone, neck pain disappeared. He recovered the muscle power by physical rehabilitation. At last it became possible for him to perform the CAPD procedure by himself and drive a car to the hospital as an out patient. In such cases of pseudotumors of the craniocervical junction, CAPD is one of the best methods for relieving the pain and muscle weakness.
颅颈交界区假瘤和破坏性脊柱关节病（DSA）是透析淀粉样变性（DAA）最严重的形式。这些病变导致的疼痛和瘫痪严重损害患者的日常生活活动（ADL）。一名54岁男性患者在接受17年血液透析（HD）治疗后出现各种形式的DAA，持续不卧床腹膜透析（CAPD）改善了其ADL。他在血液透析开始12年后首次被诊断为腕管综合征，随后出现透析肩（12年）、扳机指（12年）、骨囊肿（15年）、肌腱断裂（17年）、DSA和颅颈交界区假瘤（17年）。1989年5月进行的磁共振成像（MRI）显示颅颈交界区有一个直径30毫米的假瘤，位于部分破坏的C1和C2前方。颈部疼痛和肌肉无力使他卧床不起。在改用CAPD并给予泼尼松龙治疗6个月后，颈部疼痛消失。他通过物理康复恢复了肌肉力量。最后，他能够自己进行CAPD操作，并作为门诊患者开车去医院。在这种颅颈交界区假瘤的病例中，CAPD是缓解疼痛和肌肉无力的最佳方法之一。
