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新型冠状病毒病相关横纹肌溶解致肌红蛋白管型肾病致急性肾损伤:一例报告。

Acute kidney injury due to myoglobin cast nephropathy in the setting of coronavirus disease 2019-mediated rhabdomyolysis: a case report.

机构信息

Yale University School of Medicine, Section of Infectious Diseases, 333 Cedar Street, PO Box 208022, New Haven, CT, 06510, USA.

Yale AIDS Program, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510, USA.

出版信息

J Med Case Rep. 2022 Dec 28;16(1):491. doi: 10.1186/s13256-022-03721-z.

Abstract

BACKGROUND

We present this case of coronavirus disease 2019-associated acute kidney injury with rhabdomyolysis-with noteworthy renal biopsy findings demonstrating myoglobin cast nephropathy-to add to the limited literature on coronavirus disease 2019-related acute kidney injury and rhabdomyolysis.

CASE PRESENTATION

A 67-year-old Caucasian man presented to our hospital with 3 weeks of malaise and decreased oral intake and several days of abnormal taste, poor appetite, decrease urine output, gastrointestinal symptoms, and myalgias, and was ultimately diagnosed with coronavirus disease 2019. His hospital course was complicated by acute kidney injury and, upon workup of his renal failure, was diagnosed with myoglobin cast nephropathy due to coronavirus disease 2019-mediated rhabdomyolysis. Ultimately, his renal function improved following hydration back to his baseline 6 weeks after his initial diagnosis of coronavirus disease 2019.

CONCLUSIONS

Given our limited knowledge of manifestations of coronavirus disease 2019, it is important to have a more in-depth understanding of the spectrum of disease of coronavirus disease 2019, which can affect various organ systems, including the kidney, and the manifestations of end-organ damage associated with it. We present this case to highlight a rarely reported finding of myoglobin cast nephropathy due to coronavirus disease 2019-mediated rhabdomyolysis.

摘要

背景

我们呈现了这例与 2019 年冠状病毒病相关的急性肾损伤伴横纹肌溶解症病例,值得注意的是肾活检结果显示肌红蛋白尿肾病,这增加了关于 2019 年冠状病毒病相关急性肾损伤和横纹肌溶解症的有限文献。

病例介绍

一名 67 岁白人男性因 3 周的不适和食欲减退以及数天的异常味觉、食欲差、尿量减少、胃肠道症状和肌痛而就诊于我院,最终被诊断为 2019 年冠状病毒病。他的住院过程中并发急性肾损伤,在对其肾功能衰竭进行检查时,由于 2019 年冠状病毒病介导的横纹肌溶解症,被诊断为肌红蛋白尿肾病。最终,在最初诊断为 2019 年冠状病毒病 6 周后,通过水化治疗使他的肾功能恢复到基线水平。

结论

鉴于我们对 2019 年冠状病毒病表现的了解有限,深入了解 2019 年冠状病毒病的疾病谱非常重要,因为它可以影响包括肾脏在内的各种器官系统,以及与其相关的终末器官损伤的表现。我们提出这例病例是为了强调一个罕见的发现,即 2019 年冠状病毒病介导的横纹肌溶解症导致肌红蛋白尿肾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58ee/9798549/266afe19423a/13256_2022_3721_Fig1_HTML.jpg

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