Pena D R, Vaccarello M, Neiberger R E
JHM Health Center, University of Florida, Gainesville.
Child Nephrol Urol. 1991;11(4):223-7.
Hemolytic uremic syndrome has been associated with insulin-dependent diabetes mellitus eight times in the past, while the hemolytic uremic syndrome and rhabdomyolysis association has been described once. The occurrence of both conditions in a patient with the hemolytic uremic syndrome has not been reported. In this report, we described a 28-month-old girl who presented with severe hemolytic uremic syndrome muscle weakness and elevated muscle enzymes. Later, she developed hyperglycemia and ketosis requiring initiation of insulin therapy. The current literature was reviewed, and a hypothesis for the mechanism of injury and the multisystemic nature of this syndrome is presented. In patients with the hemolytic uremic syndrome, identification of potential extrarenal involvement is important as it may determine the final outcome of this disease.
过去，溶血性尿毒症综合征曾8次与胰岛素依赖型糖尿病相关，而溶血性尿毒症综合征与横纹肌溶解症的关联仅被描述过1次。溶血性尿毒症综合征患者同时出现这两种病症的情况尚未见报道。在本报告中，我们描述了一名28个月大的女童，她患有严重的溶血性尿毒症综合征、肌肉无力且肌肉酶升高。后来，她出现高血糖和酮症，需要开始胰岛素治疗。我们查阅了当前的文献，并提出了关于该综合征损伤机制和多系统性质的假说。对于溶血性尿毒症综合征患者，识别潜在的肾外受累情况很重要，因为这可能决定该疾病的最终结局。
