Chen Xiaoxia, Zhang Yafeng, Zhou Yue
Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, People's Republic of China.
Department of Public Health, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212003, People's Republic of China.
Int J Nephrol Renovasc Dis. 2024 Nov 30;17:301-306. doi: 10.2147/IJNRD.S490816. eCollection 2024.
Chorea is rare in maintenance dialysis patients but seriously affects the quality of life, and there are few previous reports of this condition. We report two patients undergoing regular hemodialysis for end-stage renal disease, both of whom presented with progressively intensified involuntary limb movements, but originating from different etiologies.
We report two patients undergoing regular hemodialysis for end-stage renal disease who presented with progressively intensified involuntary limb movements. Treatment with sedatives alone proved ineffective in both cases. Through differential diagnosis, one patient was diagnosed with diabetic striatopathy and managed with intensive glycemic control, while the other was found to have uremic metabolic encephalopathy and treated with a combination of hemodialysis and hemoperfusion. Subsequently the patients' symptoms improved significantly.
Choreiform movements in hemodialysis patients arise from a variety of etiologies. These two cases suggested the susceptibility to the onset of chorea in the early stage of maintenance hemodialysis.
舞蹈症在维持性透析患者中较为罕见,但严重影响生活质量,此前关于这种情况的报道较少。我们报告了两名因终末期肾病接受定期血液透析的患者,他们均出现了逐渐加重的肢体不自主运动,但病因不同。
我们报告了两名因终末期肾病接受定期血液透析且出现逐渐加重的肢体不自主运动的患者。在这两个病例中,单独使用镇静剂治疗均无效。通过鉴别诊断,一名患者被诊断为糖尿病性纹状体病,并通过强化血糖控制进行治疗,而另一名患者被发现患有尿毒症代谢性脑病,并接受了血液透析和血液灌流联合治疗。随后,患者的症状明显改善。
血液透析患者的舞蹈样动作由多种病因引起。这两个病例提示了维持性血液透析早期发生舞蹈症的易感性。