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一名易患恶性高热的患者在感染并服用感冒药后发生横纹肌溶解。

Rhabdomyolysis after infection and taking a cold medicine in a patient who was susceptible to malignant hyperthermia.

作者信息

Kasamatsu Y, Osada M, Ashida K, Azukari K, Yoshioka K, Ohsawa A

机构信息

First Department of Internal Medicine, Matsushita Memorial Hospital, Moriguchi, Osaka.

出版信息

Intern Med. 1998 Feb;37(2):169-73. doi: 10.2169/internalmedicine.37.169.

Abstract

A case of rhabdomyolysis after a possible viral infection and the use of a cold medication is reported. A 41-year-old man who presented with dysarthria, dysphagia, progressive weakness of his muscles and a high grade fever was admitted. He suffered from massive rhabdomyolysis, acute renal failure, and bronchopneumonia. Hemodialysis, antibiotics, and hydration therapy were effective in the treatment of his illness. Although the cause of the rhabdomyolysis was not completely clear, he was subsequently shown to be susceptible to malignant hyperthermia (MH) based on the results of a caffeine-halothane contracture test. When a mild recurrence occurred during a follow-up muscle biopsy, intravenous dantrolene sodium was administered and he improved immediately. This case suggests that MH should be considered in patients with rhabdomyolysis when the cause is unclear. The caffeine-halothane contracture test may also be helpful in the diagnosis.

摘要

报告了一例在可能的病毒感染及使用感冒药后发生横纹肌溶解症的病例。一名41岁男性因构音障碍、吞咽困难、进行性肌肉无力和高热入院。他患有大面积横纹肌溶解症、急性肾衰竭和支气管肺炎。血液透析、抗生素和补液疗法对其疾病治疗有效。尽管横纹肌溶解症的病因尚不完全清楚,但根据咖啡因-氟烷挛缩试验结果,他随后被证明对恶性高热(MH)易感。在随访肌肉活检期间出现轻度复发时,给予静脉注射丹曲林钠,他立即好转。该病例表明,当横纹肌溶解症病因不明时,应考虑患者患有恶性高热。咖啡因-氟烷挛缩试验对诊断也可能有帮助。

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