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患者嗜酸性粒细胞增多,维持性血液透析时发生过敏反应引发小脑出血。

Cerebellar haemorrhage triggered by allergic reaction to maintenance haemodialysis in a patient with eosinophilia.

机构信息

Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan.

Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan

出版信息

BMJ Case Rep. 2023 Feb 14;16(2):e254126. doi: 10.1136/bcr-2022-254126.

Abstract

We report a case of eosinophilia and an allergic reaction that caused a cerebellar haemorrhage.An woman in her 80s presented with headache, dyspnoea and vomiting with severe hypotension soon after switching the dialysis membrane, and a CT scan revealed cerebellar haemorrhage. In the subsequent clinical course, the patient developed an allergic reaction to multiple membranes and required corticosteroids to continue haemodialysis (HD). Pre-existing eosinophilia is a risk factor for cerebral infarctions and dialysis membrane allergy, which is a common feature in patients undergoing HD. Membrane switching and corticosteroid therapy must be considered in case of multiple membrane allergies.

摘要

我们报告了一例嗜酸性粒细胞增多和过敏反应导致小脑出血的病例。一位 80 多岁的女性在更换透析膜后不久出现头痛、呼吸困难和呕吐,伴有严重低血压,CT 扫描显示小脑出血。在随后的临床过程中,患者对多种膜发生过敏反应,需要皮质类固醇继续进行血液透析 (HD)。 先前存在的嗜酸性粒细胞增多是脑梗死和透析膜过敏的危险因素,而后者是接受 HD 治疗的患者的常见特征。如果发生多种膜过敏,必须考虑更换膜和皮质类固醇治疗。

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