Takata Tadayuki, Kokudo Yohei, Kume Kodai, Ikeda Kazuyo, Kamada Masaki, Touge Tetsuo, Deguchi Kazushi, Masaki Tsutomu
Department of Intractable Neurological Research, Kagawa University Faculty of Medicine, Japan.
Intern Med. 2016;55(15):2065-7. doi: 10.2169/internalmedicine.55.6295. Epub 2016 Aug 1.
Arachnoid cyst (AC) is a neurological complication of autosomal dominant polycystic kidney disease (ADPKD). Although an AC can increase the risk of a subdural hematoma, the clinical presentation of bleeding into an AC associated with ADPKD is not well known. We herein report the case of a 59-year-old woman in whom the initiation of hemodialysis for renal failure led to AC bleeding. A change of anticoagulant from heparin to nafamostat mesilate allowed dialysis to continue without rebleeding. These findings suggest that hemodialysis in patients with an AC associated with ADPKD may increase the risk of bleeding. Nafamostat mesilate may be useful in such cases.
蛛网膜囊肿(AC)是常染色体显性多囊肾病(ADPKD)的一种神经并发症。尽管AC会增加硬膜下血肿的风险,但与ADPKD相关的AC内出血的临床表现尚不为人所知。我们在此报告一例59岁女性病例,其因肾衰竭开始血液透析后发生了AC出血。将抗凝剂从肝素改为甲磺酸萘莫司他后,透析得以继续且未再出血。这些发现表明,患有与ADPKD相关AC的患者进行血液透析可能会增加出血风险。甲磺酸萘莫司他在此类病例中可能有用。