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与肾衰竭相关的急性亚氯酸钠中毒

Acute sodium chlorite poisoning associated with renal failure.

作者信息

Lin J L, Lim P S

机构信息

Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.

出版信息

Ren Fail. 1993;15(5):645-8. doi: 10.3109/08860229309069417.

Abstract

A 25-year-old Chinese male presented with generalized cyanosis and respiratory distress. The patient was known to have ingested 10 g of sodium chlorite in a suicide attempt. Methemoglobinemia was found and intravenous methylene blue was given repeatedly. However, the therapy could not prevent an acute hemolytic crisis. Methemoglobinemia remained profound (43.1%) and disseminated intravascular coagulation ensued. He was put on CAVHD to correct the fluid overload and probably to remove the active metabolites of the chlorite. After 24 h, the methemoglobin was reduced to 16.9%. However, the development of acute renal failure further complicated the clinical course. Percutaneous renal biopsy suggested a picture of acute tubulointerstitial nephropathy. In addition, hemodialysis was continued for 4 weeks. After 3 months, renal function normalized. To our knowledge, there has been no clinical report of human intoxication with sodium chlorite.

摘要

一名25岁的中国男性出现全身青紫和呼吸窘迫。据悉该患者曾试图自杀,摄入了10克亚氯酸钠。发现有高铁血红蛋白血症,并多次静脉注射亚甲蓝。然而,该治疗未能预防急性溶血危机。高铁血红蛋白血症仍然严重(43.1%),随后发生了弥散性血管内凝血。给他进行了连续性动静脉血液滤过透析(CAVHD)以纠正液体超负荷,并可能清除亚氯酸盐的活性代谢产物。24小时后,高铁血红蛋白降至16.9%。然而,急性肾衰竭的发生使临床病程更加复杂。经皮肾活检提示为急性肾小管间质性肾病。此外,血液透析持续了4周。3个月后,肾功能恢复正常。据我们所知,此前尚无亚氯酸钠人体中毒的临床报告。

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