Wada S, Nagase T, Koike Y, Kugai N, Nagata N
Third Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
Intern Med. 1992 Apr;31(4):478-82. doi: 10.2169/internalmedicine.31.478.
A 16-year-old girl with anorexia nervosa first presented with malnutrition, liver dysfunction, and rhabdomyolysis. Administration of fluid and nutrition saved her from the initial critical state, but acute renal failure followed. Laboratory examination revealed intrinsic renal failure induced by rhabdomyolysis. Latent phosphate depletion and refeeding-induced hypophosphatemia was implicated as the cause of rhabdomyolysis; however coexisting hypotension, dehydration, and liver dysfunction may have contributed to the renal failure. The patient recovered from azotemia by hemodialysis. This is the first reported case of anorexia nervosa with acute renal failure resulting from rhabdomyolysis induced by hypophosphatemia or phosphate depletion.
一名16岁神经性厌食症女孩首次出现时伴有营养不良、肝功能障碍和横纹肌溶解症。补液和营养支持使她脱离了最初的危急状态，但随后出现了急性肾衰竭。实验室检查显示肾衰竭是由横纹肌溶解症引起的内在性肾衰竭。潜在的磷酸盐缺乏和再喂养引起的低磷血症被认为是横纹肌溶解症的病因；然而，同时存在的低血压、脱水和肝功能障碍可能也导致了肾衰竭。患者通过血液透析从氮质血症中康复。这是首例报告的因低磷血症或磷酸盐缺乏引起横纹肌溶解症导致急性肾衰竭的神经性厌食症病例。
