Kleynberg Roman L, Kleynberg Vera M, Kleynberg Leonid M, Farahmandian Danny
Department of Internal Medicine, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA 91342-1438, USA.
Int J Nephrol. 2011;2011:469602. doi: 10.4061/2011/469602. Epub 2011 Apr 14.
Pericardial involvement in end-stage renal disease (ESRD) is manifested most commonly as acute uremic or dialysis pericarditis and infrequently as chronic constrictive pericarditis (CCP). We report a 27-year-old patient with a history of uncontrolled hypertension, end-stage-renal disease on hemodialysis, who presented with recurrent ascites, dyspnea, and hypotension. After diagnosis with CCP, a partial pericardiectomy was performed; however, the patient did not improve and a salvage total pericardiectomy soon followed. He continued to decompensate and expired following a terminal extubation. No definitive cause of constrictive pericarditis was found. Nonetheless, we surmise it may have developed secondary to his end-stage renal disease. A literature review revealed end-stage kidney disease as a relatively uncommon cause of CCP; only a few other such associations have thus far been reported.
终末期肾病(ESRD)的心包受累最常见表现为急性尿毒症性或透析相关性心包炎,很少表现为慢性缩窄性心包炎(CCP)。我们报告一名27岁患者,有未控制的高血压病史,因终末期肾病接受血液透析,出现反复腹水、呼吸困难和低血压。诊断为CCP后,进行了部分心包切除术;然而,患者病情未改善,随后很快进行了挽救性全心包切除术。他持续失代偿,最终拔管后死亡。未发现缩窄性心包炎的确切病因。尽管如此,我们推测它可能继发于他的终末期肾病。文献综述显示,终末期肾病是CCP相对少见的病因;迄今为止,仅报告了少数其他此类关联。