Bhat Anil, Bhowmik Dipankar M, Vibha Deepti, Dogra Manu, Agarwal Sanjay K
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Saudi J Kidney Dis Transpl. 2014 Jan;25(1):130-2. doi: 10.4103/1319-2442.124529.
We report a 45-year-old lady with chronic kidney disease stage 4 due to chronic tubulointerstial disease. She was admitted to our center for severe anemia due to menorrhagia and deterioration of renal function. She was infused three units of packed cells during a session of hemodialysis. Tranexamic acid (TNA) 1 g 8-hourly was administered to her to control bleeding per vaginum. Two hours after the sixth dose of TNA, she had an episode of generalized tonic clonic convulsions. TNA was discontinued. Investigations of the patient revealed no biochemical or structural central nervous system abnormalities that could have provoked the convulsions. She did not require any further dialytic support. She had no further episodes of convulsion till dis-charge and during the two months of follow-up. Thus, the precipitating cause of convulsions was believed to be an overdose of TNA.
我们报告了一位45岁因慢性肾小管间质性疾病导致慢性肾脏病4期的女性。她因月经过多导致严重贫血和肾功能恶化入住我们中心。在一次血液透析过程中，她输注了三个单位的浓缩红细胞。给予她氨甲环酸（TNA）1克，每8小时一次，以控制阴道出血。在第六剂TNA给药两小时后，她出现了一次全身性强直阵挛性惊厥。停用了TNA。对该患者的检查未发现可能引发惊厥的生化或结构性中枢神经系统异常。她不需要任何进一步的透析支持。直到出院以及在两个月的随访期间，她没有再次出现惊厥发作。因此，惊厥的诱发原因被认为是TNA过量。
