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急性铅性脑病继发于阿育吠陀药物使用:两例病例并文献复习。

Acute Lead Encephalopathy Secondary to Ayurvedic Medication Use: Two Cases with Review of Literature.

机构信息

Department of Neurosciences, Kokilaben Dhirubhai Ambani Hospital and Medical Reseacrh Center, Mumbai, Maharashtra, India.

出版信息

Neurol India. 2021 Sep-Oct;69(5):1417-1420. doi: 10.4103/0028-3886.329591.

Abstract

Ayurvedic medicine is an ancient and traditional system of health care. It is safe but inadvert and unsupervised use can lead to serious health complications. Lead is a common constituent of these medicines. Here authors describe two cases of lead encephalopathy as a result of long-term ayurvedic medication intake. First case was a 54-year-old female taking ayurvedic medications since long time presented with acute confusional state and memory disturbances with abdominal pain. MRI brain showed symmetric basal ganglia and cortical signal changes and edema with significantly elevated lead levels in blood. She responded to chelation therapy with oral penicillamine with complete clinical and radiological resolution. Second case presented was a 45-year female taking ayurvedic medications for hypertension presented with headaches and rapid deterioration in sensorium leading to coma and death. MRI brain showed diffuse cerebral edema with basal ganglia signal changes with elevated lead levels in blood. These two cases highlight the need for increased awareness that some Ayurvedic medicines may contain potentially harmful levels of lead and people who use them are at risk of developing associated toxicity which can even be fatal.

摘要

阿育吠陀医学是一种古老而传统的健康保健体系。它是安全的,但如果不小心和不受监督地使用,可能会导致严重的健康并发症。铅是这些药物的常见成分。作者在这里描述了两起因长期服用阿育吠陀药物而导致的铅性脑病病例。第一例是一位 54 岁的女性,长期服用阿育吠陀药物,表现为急性意识混乱和记忆障碍,伴有腹痛。脑部 MRI 显示对称的基底节和皮质信号改变以及水肿,血液中的铅含量明显升高。她对口服青霉素进行螯合治疗后,临床和影像学均完全缓解。第二例是一位 45 岁的女性,因高血压服用阿育吠陀药物,表现为头痛,意识迅速恶化,导致昏迷和死亡。脑部 MRI 显示弥漫性脑水肿,伴有基底节信号改变,血液中的铅含量升高。这两个病例强调了需要提高认识,即一些阿育吠陀药物可能含有潜在的有害水平的铅,而使用这些药物的人有患相关毒性的风险,甚至可能致命。

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