Retinal Arteries Occlusion in a Young Peritoneal Dialysis Patient

腹膜透析病人併發視網膜動脈阻塞症

吳明瑞(Ming-Jei Wu) ； 方華章(Hua-Chang Fang) ； 周康茹(Kang-Ju Chou) ； 李柏蒼(Po-Tsang Lee) ； 陳建良(Chien-Liang Chen) ； 鍾孝民(Hsiao-Min Chung)

《Acta Nephrologica》 20卷1期 (2006/01) Pp. 41-44

摘要

透析病患併發視網膜動脈阻塞症是相當罕見的。造成視網膜動脈阻塞的原因相當多，其中最常見的原因是頸動脈粥狀瘤引起的血栓性阻塞。另外與視網膜動脈阻塞有關的臨床疾病包括有心臟瓣膜疾病和血液凝固異常。我們提出一名接受腹膜透析的年輕女性併發視網膜動脈阻塞症的病例。此病患頸動脈超音波檢查並無異常，經食道心臟超音波沒有發現血栓形成，但僧帽瓣有厲害的鈣化。我們相信此僧帽瓣鈣化是視網膜動脈阻塞的促因。對此病患而言，僧帽瓣鈣化乃其副甲狀腺功能亢進的臨床表徵之一。在此病例報告中，我們參考相關文獻，討論此病患造成視網膜動脈阻塞症的可能機轉。

關鍵字

透析 ； 副甲狀腺功能亢進 ； 僧帽瓣鈣化 ； 視網膜動脈阻塞

並列摘要

The development of retinal artery occlusion in dialysis patients is an extremely rare occurrence. Occlusion of retinal arteries can occur secondary to a variety of etiologies. There are some clinical conditions associated with retinal artery occlusion such as valvular heart diseases and coagulation disorders. Here we present a young female peritoneal dialysis patient who developed retinal artery occlusion. The Doppler scanning of carotid artery revealed no abnormality. The trans-esophageal cardiography showed no thrombus formation but heavy calcification of mitral valves, which was believed to be the predisposing factor of retinal arteries occlusion. Coagulation disorders and other rare causes were ruled out by clinical findings and laboratory data. Mitral valves calcification was one of the systemic effects of hyperparathyroidism in this patient, which was treated with oral calcitriol and alcohol injection of parathyroid adenoma. In this report, we review the relevant articles and discuss the probable mechanism of retinal arteries occlusion in this patient.

並列關鍵字

dialysis, hyperparathyroidism ； mitral valve calcification ； retinal artery occlusion