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儿童肾移植免疫抑制治疗并发症:后部可逆性脑病综合征(PRES)

Posterior Reversible Encephalopathy Syndrome (PRES) as a Complication of Immunosuppressive Therapy in Renal Transplantation in Children.

作者信息

Hodzic Emir, Brcic Majda, Atic Mirza, Halilcevic Alma, Jasarevic Amila, Aleckovic-Halilovic Mirna, Trojak Davor, Atic Nedima, Zulic Snezana, Mehmedovic Zlatan, Iveljic Ivana

机构信息

University Clinical Center Tuzla, Clinic for Internal Diseases, Tuzla, Bosnia and Herzegovina.

University Clinical Center Tuzla, Clinic for Diseases of Children, Tuzla, Bosnia and Herzegovina.

出版信息

Med Arch. 2014 Jun;68(3):218-20. doi: 10.5455/medarh.2014.68.218-220. Epub 2014 May 31.

Abstract

Although kidney transplantation is by far the best method of renal replacement therapy, organ receiver is still not spared of eventual toxic consequences of drugs that are in charge of keeping the transplanted kidney functional. Both calcineurin inhibitors, of which tacrolimus more often, occasionally lead to neurotoxic side effects, mostly mild and reversible and dose-dependent in nature, but they can also be very severe or even fatal. It is very important to be aware of possible neurotoxic effects, to confirm them radiologically, and to prevent or reduce drug effects on nervous system. Sometimes the reduction of dose or substitution with another drug with similar mechanism effect is sufficient to terminate the neurotoxic effects of the drug and still not jeopardize the function of transplanted organ.

摘要

尽管肾移植是目前肾脏替代治疗的最佳方法,但器官接受者仍无法避免负责维持移植肾功能的药物最终产生的毒性后果。两种钙调神经磷酸酶抑制剂,其中他克莫司更为常用,偶尔会导致神经毒性副作用,大多为轻度且可逆,本质上与剂量相关,但也可能非常严重甚至致命。意识到可能的神经毒性作用、通过影像学检查加以确认以及预防或减轻药物对神经系统的影响非常重要。有时降低剂量或用另一种具有相似作用机制的药物替代就足以终止药物的神经毒性作用,同时又不会危及移植器官的功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/176b/4240331/b17062400b21/MA-68-218-g001.jpg

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