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[拉布立酶治疗新生儿急性肾损伤——病例报告]

[RASBURICASE TREATMENT FOR NEONATAL ACUTE KIDNEY INJURY - A CASE REPORT].

作者信息

Shasha-Lavsky Hadas, Awadia Pierre, Sheffer Vered, Weissman Irith

机构信息

Pediatric Nephrology Unit, Galilee Medical Center, Israel.

Azrieli Faculty of Medicine, Bar Ilan University, Israel.

出版信息

Harefuah. 2021 Dec;160(12):806-809.

Abstract

Hyperuricemia can cause renal damage and acute kidney injury or be secondary to renal failure and reduced excretion. Rasburicase, a recombinant urate oxidase, is a common treatment for hyperuricemia from different etiologies. There are scarce reports on rasburicase treatment for neonatal Acute Kidney Injury (AKI) with hyperuricemia to prevent renal damage secondary to hyperuricemia. Herein we report a case of neonatal AKI with hyperuricemia that was treated with a single dose of rasburicase. Serum uric acid declined immediately after rasburicase infusion and remained in the normal range since then. In contrast to previous reports, the normalization of uric acid levels was not accompanied by recovery from AKI and serum creatinine levels remained elevated for a long period. The neonate recovered from AKI only 2 weeks post rasburicase treatment. This case report highlights the importance of uric acid levels in neonatal AKI and suggests treatment with rasburicase in cases of hyperuricemia and acute kidney injury in neonates.

摘要

高尿酸血症可导致肾损害和急性肾损伤,或继发于肾衰竭及排泄减少。拉布立酶是一种重组尿酸氧化酶,是治疗不同病因引起的高尿酸血症的常用药物。关于拉布立酶治疗新生儿急性肾损伤(AKI)合并高尿酸血症以预防高尿酸血症继发肾损害的报道很少。在此,我们报告一例单剂量拉布立酶治疗的新生儿AKI合并高尿酸血症病例。拉布立酶输注后血清尿酸立即下降,此后一直保持在正常范围内。与之前的报道不同,尿酸水平正常化并未伴随AKI恢复,血清肌酐水平长期升高。该新生儿仅在拉布立酶治疗2周后从AKI中恢复。本病例报告强调了尿酸水平在新生儿AKI中的重要性,并建议在新生儿高尿酸血症和急性肾损伤病例中使用拉布立酶进行治疗。

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