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红细胞生成性原卟啉症严重肝损伤的成功治疗:一例报告及文献综述

Successful treatment of severe hepatic impairment in erythropoietic protoporphyria: A case report and review of literature.

作者信息

Zeng Tao, Chen Shu-Ru, Liu Hao-Qiang, Chong Yu-Tian, Li Xin-Hua

机构信息

Department of Infectious Diseases, Key Laboratory of Liver Disease of Guangdong Province, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.

Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.

出版信息

World J Hepatol. 2024 Jun 27;16(6):966-972. doi: 10.4254/wjh.v16.i6.966.

Abstract

BACKGROUND

Erythropoietic protoporphyria (EPP) is a rare genetic disorder stemming from ferrochelatase gene mutations, which leads to abnormal accumulation of protoporphyrin IX primarily in erythrocytes, skin, bone marrow and liver. Although porphyria-related severe liver damage is rare, its consequences can be severe with limited treatment options.

CASE SUMMARY

This case study highlights a successful intervention for a 35-year-old male with EPP-related liver impairment, employing a combination of red blood cell (RBC) exchange and therapeutic plasma exchange (TPE). The patient experienced significant symptom relief and a decrease in bilirubin levels following multiple PE sessions and an RBC exchange.

CONCLUSION

The findings suggest that this combined approach holds promise for managing severe hepatic impairment in EPP.

摘要

背景

红细胞生成性原卟啉病(EPP)是一种罕见的遗传性疾病,由亚铁螯合酶基因突变引起,主要导致原卟啉IX在红细胞、皮肤、骨髓和肝脏中异常蓄积。尽管卟啉病相关的严重肝损伤很少见,但其后果可能很严重,且治疗选择有限。

病例摘要

本病例研究强调了对一名35岁患有EPP相关肝损伤男性的成功干预,采用了红细胞置换和治疗性血浆置换(TPE)相结合的方法。经过多次血浆置换和一次红细胞置换后,患者症状明显缓解,胆红素水平下降。

结论

研究结果表明,这种联合方法有望用于治疗EPP中的严重肝损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc89/11212650/5aa622c1be54/WJH-16-966-g001.jpg

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