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巨大脾肿大导致的肾脏位置异常:罕见病例报告并文献复习。

Unusual renal displacement due to massive splenomegaly: a rare case report and review of literature.

机构信息

Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.

出版信息

J Int Med Res. 2024 Sep;52(9):3000605241279812. doi: 10.1177/03000605241279812.

Abstract

Here, the case of a female patient in her late 60s, who presented to hospital for a scheduled health check relating to a history of myelofibrosis for the previous 9 years, is described. She recently experienced weight loss and abdominal distention. Physical examination revealed no abnormality or tenderness. Laboratory examination showed decreased blood cells, platelets and haemoglobin, and normal renal function. Ultrasound and computed tomography scans revealed a massively enlarged spleen and displaced and compressed left kidney with abnormal features, but normal right kidney. The patient declined surgery and her myelofibrosis was treated with ruxolitinib, with a recommendation of annual follow-up observation. Despite many recorded cases of left renal displacement caused by splenomegaly, it is very rare for the left kidney to be pushed across the midline to the right side by an enlarged spleen. This article explores the causes and management of this uncommon condition and provides a review of previous literature reports with the aim of enhancing the understanding of unusual renal displacement due to massive splenomegaly, and its potential treatment options.

摘要

这里描述了一位 60 多岁的女性患者的病例。她因 9 年前的骨髓纤维化病史到医院进行定期健康检查。最近她出现了体重减轻和腹胀。体格检查未发现异常或压痛。实验室检查显示血细胞、血小板和血红蛋白减少,肾功能正常。超声和计算机断层扫描显示脾脏明显肿大,左肾移位并受压,形态异常,但右肾正常。患者拒绝手术,接受了鲁索利替尼治疗骨髓纤维化,并建议每年随访观察。尽管有许多记录的由脾肿大引起的左肾移位病例,但脾脏肿大将左肾推向右侧越过中线的情况非常罕见。本文探讨了这种罕见情况的原因和处理方法,并对以往的文献报告进行了回顾,旨在提高对由于巨大脾肿大导致的异常肾移位及其潜在治疗选择的认识。

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