Maekawa Michitaka, Imaizumi Takahiro, Yamakawa Taishi, Ito Yasuhiko
Department of Nephrology, Toyohashi Municipal Hospital, Japan.
Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2017;56(15):2001-2005. doi: 10.2169/internalmedicine.56.8328. Epub 2017 Aug 1.
A 26-year-old Japanese man without hypouricemia and with 3 previous episodes of seizures concurrent with acute kidney injury (AKI) was admitted due to an epileptic seizure, lower back pain and AKI. His creatinine kinase levels were slightly elevated. Patchy renal ischemia on contrast-enhanced computed tomography and persistent residual contrast medium was observed, consistent with acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE). Diffusion-weighted imaging (DWI) demonstrated signal changes in the corresponding area. ALPE should be considered a cause of AKI following seizures. We recommend DWI as an alternative diagnostic modality.
一名26岁的日本男性,无低尿酸血症,既往有3次癫痫发作合并急性肾损伤(AKI)病史,因癫痫发作、下背部疼痛和AKI入院。他的肌酸激酶水平略有升高。在对比增强计算机断层扫描上观察到散在性肾缺血和持续残留的造影剂,这与无氧运动后严重腰痛和散在性肾缺血导致的急性肾衰竭(ALPE)一致。扩散加权成像(DWI)显示相应区域有信号变化。ALPE应被视为癫痫发作后AKI的一个病因。我们推荐DWI作为一种替代诊断方式。