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早期识别未被怀疑的恶性高热并成功处理随后横纹肌溶解症中的严重肌红蛋白尿性肾衰竭:一例报告

Early recognition of unsuspected malignant hyperthermia and successful management of serve myoglobinuric renal failure in subsequent rhabdomyolysis: a case report.

作者信息

Lee C H, Lam K K, Fung S T, Lee C T, Hsu K T

机构信息

Department of Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC.

出版信息

Changgeng Yi Xue Za Zhi. 1998 Jun;21(2):211-6.

PMID:9729658
Abstract

Malignant hyperthermia (MH) is a rare inherited disorder of skeletal muscle, its inheritance being autosomal dominant and its mutant gene located on chromosome 19. MH is occasionally observed during general anesthesia when using some special triggering agents. In the susceptible patient, it presents with a fulminant skeletal muscle hypermetabolic crisis and proceeds to serve rhabdomyolysis. Once rhabdomyolysis is established, acute renal failure is not an inevitable consequence, yet it is the fatal complication if the condition is not appropriately managed. We describe a case of acute renal failure in the setting of rhabdomyolysis in unsuspected MH, resulting in full recovery after intermittent hemodialysis. In this case, we emphasize the importance of early recognition of MH and the favorable prognosis of subsequent myoglobinuric renal failure if treated appropriately.

摘要

恶性高热(MH)是一种罕见的遗传性骨骼肌疾病,其遗传方式为常染色体显性遗传,突变基因位于19号染色体上。在全身麻醉期间使用某些特殊触发剂时偶尔会观察到MH。在易感患者中,它表现为暴发性骨骼肌高代谢危机,并进而发展为严重的横纹肌溶解。一旦发生横纹肌溶解,急性肾衰竭并非必然结果,但如果病情未得到适当处理,它就是致命的并发症。我们描述了一例在未被怀疑为MH的情况下发生横纹肌溶解导致急性肾衰竭的病例,该患者经间歇性血液透析后完全康复。在本病例中,我们强调早期识别MH的重要性,以及如果治疗得当,随后的肌红蛋白尿性肾衰竭预后良好。

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