一例由膀胱和输尿管双侧多灶性软斑病病变引起的急性肾衰竭。
A case of acute renal failure caused by bilateral, multifocal malacoplakia lesions of the bladder and ureters.
作者信息
Bylund Jason, Pais Vernon M
机构信息
Department ofSurgery, Division of Urology, University of Kentucky Chandler Medical Center, Lexington, KY, USA.
出版信息
Nat Clin Pract Urol. 2008 Sep;5(9):516-9. doi: 10.1038/ncpuro1173.
BACKGROUND
A 51-year-old woman with a history of hypertension and a 5-year history of recurrent perimenopausal Escherichia coli urinary tract infections presented with fatigue. She had a history of occasional urinary frequency, but denied gross hematuria, flank pain, abdominal pain, immunodeficiency or immunosuppression.
INVESTIGATIONS
Basic metabolic profile, ultrasonography, cystoscopy, retrograde pyelography, pathologic evaluation of resected lesions from the bladder, ureteroscopy, pathologic evaluation of resected lesions from the ureters, and MRI.
DIAGNOSIS
Acute renal failure caused by bilateral, multifocal malacoplakia lesions of the bladder and ureters.
MANAGEMENT
Endoscopic resection and laser ablation, ureteral stent placement, and medical treatment with fluoroquinolones, vitamin C and bethanechol.
背景
一名51岁女性，有高血压病史，复发性围绝经期大肠杆菌尿路感染病史5年，出现疲劳症状。她有偶尔尿频的病史，但否认肉眼血尿、胁腹痛、腹痛、免疫缺陷或免疫抑制。
检查
基本代谢指标、超声检查、膀胱镜检查、逆行肾盂造影、膀胱切除病变的病理评估、输尿管镜检查、输尿管切除病变的病理评估以及磁共振成像。
诊断
双侧膀胱和输尿管多灶性软斑病病变导致的急性肾衰竭。
治疗
内镜下切除和激光消融、输尿管支架置入，以及使用氟喹诺酮类药物、维生素C和氨甲酰甲胆碱进行药物治疗。
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