一名氯胺酮诱发的溃疡性膀胱炎患者发生获得性高铁血红蛋白血症：病例报告
Acquired Methemoglobinemia in a Ketamine-induced Ulcerative Cystitis Patient: A Case Report.
作者信息
Kozik Spencer, Kirkham Cali, Sudario Gabriel
机构信息
University of California - Irvine, School of Medicine, Irvine, California.
University of California - Irvine Medical Center, Department of Emergency Medicine, Orange, California.
出版信息
Clin Pract Cases Emerg Med. 2022 May;6(2):137-140. doi: 10.5811/cpcem.2022.1.55277.
INTRODUCTION
As ketamine gains traction as an alternative to opiates in the treatment of chronic pain, ketamine-induced ulcerative cystitis is now being recognized as a complication of its use. The first-line treatment is phenazopyridine, an over-the-counter medication for dysuria that historically has been known to cause methemoglobinemia. This report details the case of a patient presenting to the emergency department (ED) with methemoglobinemia.
CASE REPORT
A 66-year-old woman with a complicated medical history presented to the ED with anemia and hypoxia after extended use of phenazopyridine for treatment of ketamine-induced ulcerative cystitis. She was found to have methemoglobinemia secondary to phenazopyridine used to treat her ketamine-induced ulcerative cystitis, a previously undocumented sequelae of chronic ketamine use. She was admitted to the hospital for three days and made a full recovery.
CONCLUSION
This case highlights the need to suspect ketamine-induced ulcerative cystitis in patients who use ketamine chronically and be judicious in the use of phenazopyridine for symptom management to prevent life-threatening complications.
引言
随着氯胺酮作为阿片类药物替代品在慢性疼痛治疗中越来越受到关注，氯胺酮诱发的溃疡性膀胱炎目前被认为是其使用的一种并发症。一线治疗药物是非那吡啶，一种用于治疗排尿困难的非处方药，长期以来已知其会导致高铁血红蛋白血症。本报告详细介绍了一名因高铁血红蛋白血症就诊于急诊科（ED）的患者病例。
病例报告
一名有复杂病史的66岁女性，在长期使用非那吡啶治疗氯胺酮诱发的溃疡性膀胱炎后，因贫血和缺氧就诊于急诊科。她被发现患有因用于治疗氯胺酮诱发的溃疡性膀胱炎的非那吡啶所致的高铁血红蛋白血症，这是慢性氯胺酮使用之前未记录的后遗症。她住院三天并完全康复。
结论
本病例强调了对于长期使用氯胺酮的患者，需要怀疑氯胺酮诱发的溃疡性膀胱炎，并在使用非那吡啶进行症状管理时谨慎行事，以预防危及生命的并发症。
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