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[由卟啉原生成药物引发的急性间歇性卟啉症的神经并发症及血红素精氨酸治疗的疗效]

[Neurological complications of acute intermittent porphyria precipitated by porphyrinogenic drugs and efficiency of heme-arginate treatment].

作者信息

Akopova-Larbi Rousanna, Ben Youssef Turki Ilhem, Gargouri Amina, Kraoua Ichraf, Gouider Riadh, Gouider-Khouja Neziha

机构信息

Service de Neurologie, Hôpital Razi, Manouba, Tunis.

出版信息

Tunis Med. 2009 Sep;87(9):621-6.

Abstract

BACKGROUND

Acute intermittent porphyria (AIP) is a rare metabolic disorder of heme biosynthesis characterized by enzymatic defect of porphobiligen desaminase with accumulation and increased excretion of porphyrins and their precursors. Clinical picture is characterized by attacks with a triad of abdominal pain, psychiatric disorder and neurological involvement (central and peripheral). Peripheral nervous system manifestations, often precipitated by porphyrinogenic medications are of poor outcome.

AIM

We report a new cases A 13-year-old girl who presented several attacks of AIP and developed acute severe axonal motor neuropathy, three weeks after porphyrinogenic medications (Famotidin, Phenobarbital and Nifedipine).

CONCLUSION

We stress on the importance of early diagnosis of AIP to prevent serious neurological complications often precipitated by medications and the efficiency of heme arginate treatment when administrated early during the attacks.

摘要

背景

急性间歇性卟啉病(AIP)是一种罕见的血红素生物合成代谢紊乱疾病,其特征是胆色素原脱氨酶存在酶缺陷,导致卟啉及其前体物质蓄积并排泄增加。临床表现以腹痛、精神障碍和神经受累(中枢和外周)三联征为特点的发作。由卟啉生成性药物引发的外周神经系统表现预后较差。

目的

我们报告一例新病例,一名13岁女孩出现数次AIP发作,并在使用卟啉生成性药物(法莫替丁、苯巴比妥和硝苯地平)三周后发展为急性严重轴索性运动神经病。

结论

我们强调早期诊断AIP对于预防常由药物引发的严重神经并发症的重要性,以及在发作早期给予精氨酸血红素治疗的有效性。

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