Aparato Digestivo, Hospital Clínico Universitario de Valladolid, España.
Rev Esp Enferm Dig. 2021 Aug;113(8):617. doi: 10.17235/reed.2020.7467/2020.
We present the case of a 45-year-old male with alcoholic liver cirrhosis Child-Pugh C and chronic left lower limb lymphedema, hospitalized because of ascites and renal impairment (Cr 2.33 mg/dl). He received intravenous albumin and terlipressin (1 mg every 4h) for suspected hepatorenal syndrome. After 48 hours, purpuric skin lesions appeared on both lower extremities, scrotum and umbilical hernia. Renal function improved (Cr 0.49 mg/dl). Nevertheless, terlipressin was discontinued as the skin lesions worsened due to epidermal detachment, and oral sildenafil was administered at 50 mg twice per day. The left lower limb was severely affected with extensive skin and soft tissue necrosis, which led to supracondylar amputation. All the other lesions had a satisfactory evolution, with reepithelialization of the damaged areas.
我们报告了一例 45 岁男性病例，患有酒精性肝硬化 Child-Pugh C 级和慢性左下肢淋巴水肿，因腹水和肾功能损害（Cr 2.33mg/dl）住院。他因疑似肝肾综合征接受静脉注射白蛋白和特利加压素（1mg，每 4 小时一次）治疗。48 小时后，双下肢、阴囊和脐疝出现紫癜性皮损。肾功能改善（Cr 0.49mg/dl）。然而，由于皮肤脱屑导致皮损恶化，停用了特利加压素，并给予口服西地那非，每日两次，每次 50mg。左下肢严重受累，广泛皮肤和软组织坏死，导致髁上截肢。所有其他病变均有满意的演变，受损区域重新上皮化。
