Department of Emergency Medicine, Leuven University Hospital, Belgium.
Department of Emergency Medicine, AZ Maria Middelares, Ghent, Belgium.
Acta Clin Belg. 2022 Feb;77(1):219-226. doi: 10.1080/17843286.2020.1792685. Epub 2020 Jul 13.
A previously 42-year-old healthy man was brought in by an ambulance to the emergency department with symptoms of a distributive shock. He experienced a rapid decline in his clinical state that evolved into a cardiac arrest. Despite all the performed measures and a prolonged resuscitation, the patient died a few hours later without an initial clear diagnosis. Lab results showed an extremely high haemoconcentration leading to further investigations which suggested the possibility of Clarkson's disease, although septic shock as an alternative diagnosis could not be excluded. Nevertheless, because of its presentation, especially emergency and intensive care physicians should be aware of the existence of this condition in the event of an unexplained refractory distributive shock in combination with haemoconcentration and hypoalbuminemia given its possible fatal outcome.
一位 42 岁的既往健康男性因休克表现由救护车被送往急诊。他的临床状态迅速恶化，继而发生心搏骤停。尽管采取了所有措施并进行了长时间的复苏，患者仍在数小时后死亡，且最初没有明确的诊断。实验室结果显示极高的血浓缩，进一步检查提示存在克拉克森病的可能，尽管不能排除感染性休克作为替代诊断。然而，鉴于其表现，特别是在出现原因不明的难治性分布性休克合并血浓缩和低白蛋白血症时，即使存在感染性休克，紧急和重症监护医生也应该意识到这种疾病的存在，因为它可能导致致命后果。
