Rhabdomyolysis-Induced Acute Tubular Necrosis after the Concomitant Use of Alcohol and Pentazocine-A Case Report

本病例是位二十六歲男性病人，因服用大量酒精同時又注射噃他唑新〈速賜康〉、遂發生意識障锝，三天後以主訴乏尿，左下肢浮腫而入院。住院後經檢查診斷為橫紋肌壞死併發急性腎衰竭，腎臟切片主要病理變化是腎小管空泡性壞死和細胞內器官退化性變化，肌肉切片主要病理變化是第一型肌細胞呈現空泡性壞死及萎縮現象。病人接受兩次腹膜透析治療後，腎功能逐漸恢復尿量漸增而進入利尿期，不幸病人卻發生高鈣血症，TC99m骨骼掃描顯示兩側肺部、胃部、左下肢各部位放射性攝取增加，有軟組織鈣化現象，經追蹤複檢此異常顯象逐漸消失，血清離子鈣化亦回復正常。病人出院時，腎功能及肺功能皆正常，但患者做側上下肢和左軀幹肌肉萎縮之後遺症。因酗酒和濫用?他唑新之問題日趨嚴重，而且由這兩者導致橫紋肌壞死引起急性腎小管壞死之病例在台灣地區尚未有報告，故特提出報告並討論其致病機轉。

關鍵字

無資料

並列摘要

A 26 year-old male patient developed rapid deterioration of renal function after the concomitant use of alcohol and pentazocine. A renal biopsy showed vacuolar necrosis and organelle degeneration in the renal tubular cells. A muscle biopsy revealed central vacuolar necrosis and atrophic change in the typeⅠmyocytes. Rhabdomyolysis-induced acute tubular necrosis was diagnosed according to the clinical and pathological findings. The patient received two courses of peritoneal dialysis. Renal function recovered gradually, but hypercalcemia developed during the diuretic phase. A TC99m bone scan showed increased radiouptakes of metastatic calcification in both lungs, stomach, left thigh and left pretibial region. The serum ionized calcium level during the follow-up period. On discharge. The patient maintained normal trunk. The possible mechanism of acute renal failure after the concomitant use of alcohol and pentazocine will be discussed.

並列關鍵字

alcohol ； pentazocine ； rhabdomyolysis

國際替代計量

Rhabdomyolysis-Induced Acute Tubular Necrosis after the Concomitant Use of Alcohol and Pentazocine-A Case Report

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