Milo R, Neuman M, Klein C, Caspi E, Arlazoroff A
Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
Obstet Gynecol. 1989 Mar;73(3 Pt 2):450-2.
A 27-year-old, previously healthy normotensive woman was admitted for hyperemesis gravidarum and treated with intravenous fluids and metoclopramide. Thereafter, a neuropsychiatric syndrome developed, with acute asymmetrical axonal motor-sensory polyneuropathy and marked anxiety, depression, irritability, and memory and concentration difficulties. Raised porphyrin precursors were found in the patient's urine, but not in her feces. Although the association of acute porphyria and pregnancy is rare, the pregnancy itself, combined with a state of starvation, and the administration of metoclopramide, could have precipitated the acute attack in this case. Thiamine deficiency, Guillain-Barré syndrome, and an obstetric complication producing closely related symptoms were excluded. The drug was stopped and the patient was treated with a high-carbohydrate diet and physiotherapy. A normal infant was delivered spontaneously at term.
一名27岁、既往健康的血压正常女性因妊娠剧吐入院，接受了静脉补液和甲氧氯普胺治疗。此后，出现了一种神经精神综合征，伴有急性非对称性轴索性运动感觉性多发性神经病，以及明显的焦虑、抑郁、易怒，还有记忆力和注意力方面的问题。在患者尿液中发现卟啉前体升高，但粪便中未发现。尽管急性卟啉病与妊娠的关联很少见，但妊娠本身、饥饿状态以及甲氧氯普胺的使用，在本病例中可能引发了急性发作。排除了硫胺素缺乏、吉兰 - 巴雷综合征以及产生密切相关症状的产科并发症。停用了该药物，患者接受了高碳水化合物饮食和物理治疗。足月时自然分娩出一名正常婴儿。
