住院患者因注射吸毒所致获得性A淀粉样变性伴自发性脾破裂：一例报告
Acquired A amyloidosis from injection drug use presenting with atraumatic splenic rupture in a hospitalized patient: a case report.
作者信息
Roll Garrett R, Lee Andrew Y, Royaie Kayvan, Visser Brendan, Hanks Douglas K, Knudson Margaret M, Roll Frederick J
机构信息
Department of Surgery, University of California San Francisco, San Francisco, USA.
出版信息
J Med Case Rep. 2011 Jan 24;5:29. doi: 10.1186/1752-1947-5-29.
INTRODUCTION
Little is known about splenic rupture in patients who develop systemic acquired A amyloidosis. This is the first report of a case of atraumatic splenic rupture in a patient with acquired A amyloidosis from chronic injection drug use.
CASE PRESENTATION
A 58-year-old Caucasian man with a long history of injection drug use, hospitalized for infective endocarditis, experienced atraumatic splenic rupture and underwent splenectomy. Histopathological and microbiological analyses of the splenic tissue were consistent with systemic acquired A amyloidosis, most likely from injection drug use, that led to splenic rupture without any recognized trauma or evidence of bacterial embolization to the spleen.
CONCLUSION
In patients with chronic inflammatory conditions, including the use of injection drugs, who experience acute onset of left upper quadrant pain, the diagnosis of atraumatic splenic rupture must be considered.
引言
对于发生系统性获得性A淀粉样变性的患者的脾破裂情况，人们了解甚少。本文首次报道了一例因长期注射吸毒导致获得性A淀粉样变性的患者发生非创伤性脾破裂的病例。
病例介绍
一名58岁的白种男性，有长期注射吸毒史，因感染性心内膜炎住院，发生了非创伤性脾破裂并接受了脾切除术。脾组织的组织病理学和微生物学分析与系统性获得性A淀粉样变性一致，很可能是由注射吸毒引起的，导致脾破裂，没有任何公认的创伤或脾脏细菌栓塞的证据。
结论
对于患有慢性炎症性疾病（包括注射吸毒）且出现左上腹疼痛急性发作的患者，必须考虑非创伤性脾破裂的诊断。
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