- 期刊
- OpenAccess
Hemolytic-Uremic Syndrome Following Excessive Heroin Inhalation
伴隨大量海洛因吸食後的溶血性尿毒症性症候群
摘要
一位32歲男性在吸食大量海洛因後發生急性腎衰竭，微血管病變性溶血性貧血及血小板減少的現象。病人的腎臟切片顯示微血管形之腎臟微血管病變。我們以血液透析來治療病人的急性腎衰竭並以血漿置換術來治療溶血性尿毒症性症候群。此病人逐漸穩定而康復出院但至今仍需依靠血液透析的治療。據我們所知，這是文獻上第一位海洛因吸食後的溶血性尿毒症性症候群病例。文章中，我們討論了嗎啡類毒品引起溶血性尿毒症性症候群的表現及海洛因可能的致病機轉。
並列摘要
Hemolytic uremic syndrome (HUS) can be simply classified into typical and atypical/adult HUS. Typical HUS with glomerular thrombotic microangiopathy is a common cause of acute renal failure in children associated with diarrhea, and portends a favorable prognosis. In contrast, atypical/adult HUS is characterized by arteriolar lesions in renal vasculature and is usually associated with poor outcome, more renal sequelae, severe hypertension and may require specific treatment. Atypical/adult HUS associated with oral contraceptives, antineoplastic agents, ticlopidine, quinine and ‘crack cocaine’ has been previously reported. We found a 32-year-old male who suffered from acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia after a large dose of heroin inhalation. His renal biopsy showed conspicuous thickening of arteriolar and arterial walls with swelling of endothelial and mucoid change of intima. Ischemic changes of glomeruli and collapse of the glomerular tufts were also seen, and that suggested the vascular type of renal microangiopathy. Emergency hemodialysis was arranged for acute renal failure and plasma exchange with fresh frozen plasma for hemolytic uremic syndrome. He survived after plasma exchange but still remains on hemodialysis. To date, he was the first case of hemolytic uremia syndrome associated with heroin via the route of inhalation.