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新型冠状病毒肺炎导致一名年轻成年人发生横纹肌溶解症,需要进行血液透析。

COVID-19 causing rhabdomyolysis requiring hemodialysis in a young adult.

作者信息

Mittal Nitish, Del Rio-Pertuz Gaspar, Abohelwa Mostafa

机构信息

School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

出版信息

Proc (Bayl Univ Med Cent). 2022 Mar 22;35(4):510-511. doi: 10.1080/08998280.2022.2051787. eCollection 2022.

Abstract

Cases of rhabdomyolysis causing myoglobinuria in post-COVID-19 patients have been seen, and exact mechanisms behind it seem multifactorial. Some patients have severe myoglobinuria with highly elevated creatinine phosphokinase levels requiring urgent hemodialysis to keep creatinine and blood urea nitrogen levels under control and protect the kidneys from long-term damage. Here, we present a case of a 34-year-old man with a history notable for autism and hypertension who was admitted to the hospital for COVID-19 viral pneumonia and discharged without major complications. After 3 weeks, he came to the emergency room with decreased mental status and asterixis. He had red-colored urine and acute kidney injury secondary to rhabdomyolysis. His creatinine phosphokinase was 289,500 mcg/L-a level never reported before. The patient did not respond to aggressive intravenous fluids, so he was started on hemodialysis. After 1 week, he showed clinical improvement, and he was taken off dialysis in 2 weeks.

摘要

在新冠病毒感染后的患者中已出现横纹肌溶解导致肌红蛋白尿的病例,其背后的确切机制似乎是多因素的。一些患者出现严重的肌红蛋白尿,肌酸磷酸激酶水平大幅升高,需要紧急进行血液透析以控制肌酐和血尿素氮水平,并保护肾脏免受长期损害。在此,我们报告一例34岁男性病例,其有自闭症和高血压病史,因新冠病毒肺炎入院,出院时无重大并发症。3周后,他因精神状态减退和扑翼样震颤来到急诊室。他出现红色尿液,继发于横纹肌溶解的急性肾损伤。他的肌酸磷酸激酶为289,500 mcg/L,这一水平此前从未有过报道。该患者对积极的静脉补液无反应,因此开始进行血液透析。1周后,他显示出临床改善,2周后停止透析。

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Pediatric COVID-19-associated rhabdomyolysis: a case report.儿童 COVID-19 相关横纹肌溶解症:病例报告。
Pediatr Nephrol. 2020 Aug;35(8):1517-1520. doi: 10.1007/s00467-020-04617-0. Epub 2020 May 23.

本文引用的文献

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COVID-19 and Rhabdomyolysis.新型冠状病毒肺炎与横纹肌溶解症
J Gen Intern Med. 2020 Oct;35(10):3087-3090. doi: 10.1007/s11606-020-06039-y. Epub 2020 Jul 15.
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Clinical Characteristics of Coronavirus Disease 2019 in China.《中国 2019 年冠状病毒病临床特征》
N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.

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