Lee D K, Do J K, Kim Y J
Department of Neurology and Pathology, Catholic University of Taegu-Hyosung School of Medicine, Taegu, Korea.
J Korean Med Sci. 1997 Apr;12(2):151-6. doi: 10.3346/jkms.1997.12.2.151.
We reported a 43-year-old woman who showed a Guillain-Barré like syndrome associated with acute renal failure (ARF) and thrombocytopenia following acute viral hepatitis A(HA). The clinical feature was acute progressive and of ascending symmetric paraparesis which developed 5 days after gastrointestinal infection. Neurologic examination showed flaccid paraparesis, areflexia in all extremities and limitation on the straight leg raising test. Laboratory examinations showed the evidences of ARF, thrombocytopenia and HA. EMG findings suggested a polyradiculopathy. Renal biopsy showed the findings of acute interstitial nephritis, acute tubular necrosis and IgA deposition nephropathy. She was treated by plasmapheresis and platelet transfusion, then showed a rapid improvement, and has been well without further complication after discharge.
我们报告了一名43岁女性,她在急性甲型肝炎(HA)后出现了与急性肾衰竭(ARF)和血小板减少相关的吉兰-巴雷综合征样综合征。临床特征为急性进行性上升性对称性双下肢轻瘫,在胃肠道感染后5天出现。神经系统检查显示双下肢弛缓性轻瘫、四肢腱反射消失以及直腿抬高试验受限。实验室检查显示有ARF、血小板减少和HA的证据。肌电图结果提示多发性神经根病。肾活检显示急性间质性肾炎、急性肾小管坏死和IgA沉积性肾病的表现。她接受了血浆置换和血小板输注治疗,随后迅速好转,出院后未出现进一步并发症,情况良好。