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意外一氧化碳中毒后出现中枢性尿崩症和高血糖高渗状态

Central Diabetes Insipidus and Hyperglycemic Hyperosmolar State Following Accidental Carbon Monoxide Poisoning.

作者信息

Ul Abideen Zain, Mahmud Syed Nayer, Rasheed Amna, Farooq Qasim Yusaf, Ali Furqan

机构信息

Nephrology and Renal Transplant, Shifa International Hospital, Islamabad, Pakistan.

Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.

出版信息

Cureus. 2017 Jun 3;9(6):e1305. doi: 10.7759/cureus.1305.

Abstract

Carbon monoxide poisoning is common and carries significant morbidity and mortality. The nervous system, particularly the brain, is frequently affected by it, owing to its high metabolic activity and oxygen requirements. Carbon monoxide damages the nervous system by both hypoxic and inflammatory mechanisms. Central diabetes insipidus is an extremely rare complication of carbon monoxide poisoning. Herein, we report the case of a young lady, who developed this complication and severe hypernatremia after accidental carbon monoxide poisoning. She also developed a hyperglycemic hyperosmolar state during the treatment for hypernatremia. To the best of our knowledge, both these entities have not been reported together in association with carbon monoxide poisoning. The purpose of this article is to emphasize the anticipation and early recognition of central diabetes insipidus in carbon monoxide poisoning. This can prevent severe hypernatremia and complications associated with its presence and treatment.

摘要

一氧化碳中毒很常见,会导致严重的发病率和死亡率。神经系统,尤其是大脑,因其高代谢活动和氧气需求,经常受到一氧化碳中毒的影响。一氧化碳通过缺氧和炎症机制损害神经系统。中枢性尿崩症是一氧化碳中毒极其罕见的并发症。在此,我们报告一例年轻女性病例,她在意外一氧化碳中毒后出现了这种并发症和严重高钠血症。在治疗高钠血症期间,她还出现了高血糖高渗状态。据我们所知,这两种情况尚未与一氧化碳中毒同时报道。本文的目的是强调对一氧化碳中毒患者中枢性尿崩症的预测和早期识别。这可以预防严重高钠血症及其存在和治疗相关的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb94/5493463/1f733380e274/cureus-0009-00000001305-i01.jpg

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