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一例罕见的由梅毒合并恶性高血压性肾病导致的失明。

A Rare Case of Blindness Caused by Syphilis with Malignant Hypertensive Nephropathy.

机构信息

Department of Nephrology, Kyoto University, Japan.

Department of Neurosurgery, Kyoto University, Japan.

出版信息

Intern Med. 2023 Nov 1;62(21):3195-3201. doi: 10.2169/internalmedicine.1436-22. Epub 2023 Mar 22.

Abstract

The number of patients with syphilis has been rapidly increasing. Without treatment, syphilis can damage various organs and become life-threatening. We herein report a 29-year-old woman diagnosed with neurosyphilis, acute hydrocephalus, syphilitic uveitis combined with hypertensive retinopathy, and malignant hypertensive nephropathy. To our knowledge, this is the first report of syphilis complicated with malignant hypertensive nephropathy proven by a renal biopsy. Neurosyphilis was successfully treated with intravenous penicillin G, and severe hypertension subsequently resolved. However, delayed medical examinations and complications of syphilitic uveitis and hypertensive retinopathy resulted in irreversible visual loss. To prevent irreversible organ damage, early treatment is essential.

摘要

梅毒患者数量迅速增加。未经治疗,梅毒可损害各种器官,危及生命。本文报告了一例 29 岁女性,诊断为神经梅毒、急性脑积水、梅毒性葡萄膜炎合并高血压性视网膜病变和恶性高血压性肾病。据我们所知,这是首例经肾活检证实的梅毒合并恶性高血压性肾病的报告。神经梅毒经静脉注射青霉素 G 成功治疗,严重高血压随后得到缓解。然而,梅毒性葡萄膜炎和高血压性视网膜病变的延迟检查和并发症导致不可逆转的视力丧失。为了防止不可逆转的器官损伤,早期治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1119/10686734/a2cb1ef3a141/1349-7235-62-3195-g001.jpg

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