癫痫持续状态伴高尿酸血症后的横纹肌溶解症：一例报告及文献综述
Rhabdomyolysis following status epilepticus with hyperuricemia: A case report and literature review.
作者信息
Wang Lingxing, Hong Shanyan, Huang Honghong, Yang Meili
机构信息
Department of Neurology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
出版信息
Medicine (Baltimore). 2018 Jun;97(26):e11281. doi: 10.1097/MD.0000000000011281.
RATIONALE
Rhabdomyolysis owing to status epilepticus (SE) can be life-threating, with acute kidney injury (AKI) the most serious complication; therefore, early recognition of the risk factors is important. Hyperuricemia after epileptic seizures has been reported, and severe hyperuricemia can lead to acute renal function damage.
PATIENT CONCERNS
We present the case of a 21-year-old man hospitalized for SE, who had especially high level of blood uric acid (UA) at initial presentation.
DIAGNOSIS
The patient was diagnosed with rhabdomyolysis due to SE.
INTERVENTIONS
The patient was treated with hydration and bicarbonate therapy. But he developed acute kidney failure (AKF) and hemodialysis was performed.
OUTCOMES
After hemodialysis, his symptoms disappeared and laboratory data returned to normal.
LESSONS
Hyperuricemia after SE might indicate severe muscle damage or reduced clearance of metabolites, and could be a risk factor for kidney dysfunction, especially with rhabdomyolysis. To our knowledge, this is the first report of rhabdomyolysis following SE with hyperuricemia.
理论依据
癫痫持续状态（SE）所致横纹肌溶解症可能危及生命，急性肾损伤（AKI）是最严重的并发症；因此，早期识别危险因素很重要。癫痫发作后高尿酸血症已有报道，严重的高尿酸血症可导致急性肾功能损害。
患者情况
我们报告一例因SE住院的21岁男性病例，其初诊时血尿酸（UA）水平特别高。
诊断
该患者被诊断为SE所致横纹肌溶解症。
干预措施
患者接受了补液和碳酸氢盐治疗。但他发展为急性肾衰竭（AKF）并进行了血液透析。
结果
血液透析后，他的症状消失，实验室数据恢复正常。
经验教训
SE后高尿酸血症可能表明严重的肌肉损伤或代谢产物清除减少，可能是肾功能不全的危险因素，尤其是在横纹肌溶解症时。据我们所知，这是首例SE后伴高尿酸血症的横纹肌溶解症报告。
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