腎病症候羣併發大腦梗塞：一病例報告

本病例是一位13歲大男童，罹患腎病症候羣已大約有3年，對類固醇治療反應不佳，病情常反覆發作，經腎臓活體切片檢查，診斷為IgM nephropathy的病例。在其罹患該病後的一年，突然左半側身子嚴重偏癱，肌肉張力及深部肌腱反射消失，經腦部電腦斷層掃描發現右側中大腦動脈分佈的顳葉，有缺血現象。經使用降腦壓藥物、補充所欠缺的電解質，及一般支持療法後，病童的情況於次日獲得穩定。這種脊病症候羣併發大腦梗塞極可能與血液凝固因子異常有關，特提出報告。

關鍵字

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並列摘要

A 13-year-old boy was admitted to this hospital for evaluation of pitting edema of both legs. Three years ago, he had been diagnosed to have nephrotic syndrome. Two and half years ago, because of persistent heavy proteinuria, poor reponse to steroids and frequent relapse of disease, a renal biopsy was done; characteristics of IgM nephropathy was shown. About a year previously, the patient felt dizziness and weakness of the left side of his body upon awakening one morning. Neurologic examination showed loss of muscle tone, muscle power and deep tendon reflexes. Sensory and cranial nerve function were intact. Blood pressure was normal The CT scan of brain showed a patch of low attenuation area in the right temporal region, obliteration of the right cortical sulci and mild compression of right lateral ventricle. A diagnosis of nephrotic syndrome with right cerebral infarction was made. The patient's condition became stable two days later after mannitol infusion, correction of electrolytes, and supportive therapy. According to literature, most cases of nephrotic syndrome complicate with renal thrombosis, pulmonary emboli, and deep vein thrombosis. Few cases complicate with cerebral thrombosis and infarction. If patient have low plasma albumin and anti-thrombin III level, hyperfunction of platelet aggregability and use long-term diuretic therapy, they may be at higher risk of thromboembolic complications. If thromboembolic complications exist, anticoagulation treatment should be instituted. Prophylactic therapy with aspirin or dicumarol is not currently recommended.

並列關鍵字

nephritic syndrome ； cerebral infarction ； thromboembolism

國際替代計量

腎病症候羣併發大腦梗塞：一病例報告

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