Nguyen Viva, Deeb Khaled, Rathakrishnan Ranga
Internal Medicine Resident, University of Miami JFK GME, Atlantis, FL, USA.
Department of Internal Medicine, Hospitalist, West Palm Beach Veterans Affairs Medical Center, West Palm Beach, FL, USA.
SAGE Open Med Case Rep. 2020 Sep 30;8:2050313X20962641. doi: 10.1177/2050313X20962641. eCollection 2020.
Hiccups are usually benign processes that most people experience with spontaneous resolution. However, persistent hiccups with a duration greater than 48 h may prompt a thorough workup for structural, infectious, or inflammatory disorders. Moreover, toxic-metabolic states, including renal dysfunction and/or uremia, have also been identified as sources of hiccups. We present a 62-year-old male with persistent hiccups that developed acute, worsening renal function. Workup for a possible intrinsic renal disease process was negative. Ultimately, a kidney biopsy was performed, demonstrating acute tubular injury with oxalate crystals and interstitial fibrosis. Dialysis was initiated with resolution of the hiccups, and kidney function improved over an extended period of time.
打嗝通常是良性过程，大多数人经历后会自行缓解。然而，持续时间超过48小时的持续性打嗝可能会促使对结构性、感染性或炎症性疾病进行全面检查。此外，包括肾功能不全和/或尿毒症在内的毒性代谢状态也被确定为打嗝的原因。我们报告一名62岁男性，他出现持续性打嗝并伴有急性肾功能恶化。对可能的原发性肾脏疾病过程的检查结果为阴性。最终进行了肾活检，显示有草酸钙结晶和间质纤维化的急性肾小管损伤。开始透析后打嗝消失，肾功能在较长一段时间内有所改善。
