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- Spontaneous Cellulitis in Adults with Idiopathic Nephrotic Syndrome
- Spontaneous Bacterial Peritonitis in Adult Patients with Primary Nephrotic Syndrome
- Calcium and Vitamin D Metabolism during Relapse in Childhood Idiopathic Nephrotic Syndrome
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- 孩童期原發性腎病症候群治療的新進展
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- Focal Glomerulosclerosis: A Clinico-Pathological Analysis of 36 Adult Patients with Idiopathic Nephrotic Syndrome
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- 兒童原發性腎病症候群
頁籤選單縮合
題名 | Spontaneous Cellulitis in Adults with Idiopathic Nephrotic Syndrome=成人原發性腎病症候群併自發性組織蜂窩炎 |
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作者 | 鄭元富; 莊峰榮; 陳靖博; 廖上智; 林景坤; 許國泰; | 書刊名 | 長庚醫學 |
卷期 | 21:2 1998.06[民87.06] |
頁次 | 頁158-164 |
分類號 | 415.74 |
關鍵詞 | 原發性腎病症候群; 自發性組織蜂窩炎; Idiopathic nephrotic syndrome; Spontaneous cellulitis; |
語文 | 英文(English) |
中文摘要 | 背景:腎病症候群的病人得到感染是很常見的問題。在小孩腎病症候群的病人常 會有自發性組織蜂窩炎的感染,但是在成人腎病症候群的病人則不常見。本研究是為了明暸 成人腎病症候群罹患自發性組織蜂窩炎的臨床變及預後。 方法:本文採回溯性分析高雄長庚紀念醫院11年來的17例原發性成人腎病症候群罹患 自發性組織蜂窩炎病人。 結果:病人平均年齡為29歲,男性12人,女性5人。病人腎臟切片的病理報告以微小 腎絲球病變最為常見,佔76%。所有的病人全身都嚴重浮腫,而自發性組織蜂窩炎幾乎都 發生在支撐身體最低的部位(dependent site)。病人臨床表現主要以全身不適、發燒、畏冷 為主,有的僅侷限於局部皮膚的疼痛。病人血漿白蛋白平均值為1.28 g/dl,每天蛋白尿流失 平均值為87.5g。血液的細菌培養顯示大腸桿菌(18%)、革蘭氏陰性桿菌(6%)、草綠色鏈 球菌(6%)、肺炎鏈球菌(6%)及沒長細菌(64%)。大部份的病人對抗生素治療反應良好, 只有1位病人因嚴重的敗血症而死亡。 結論:有關腎病症候群病人罹患自發性組織蜂窩炎的可能因素是全身水腫、低白蛋白 血症、使用抑制免疫系統用藥及病人本身免疫能力的缺失。幾乎所有的病人對抗生素及保守 治療都有很好的反應。我們結論早期診斷早期治療,病人有較好的預後。 |
英文摘要 | Background: Susceptibility to infection is a common problem in a patient with nephrotic syndrome. The spontaneous cellulitis is not uncommon in pediatric patients with nephrotic syndrome, whereas there have been few cases reported in adults. In order to clarify the clinical course of this complication. We present 17 adult idiopathic nephrotic patients with spontaneous cellulitis. Materials and Methods: A series of 17 adult idiopathic nephrotic syndrome patients with spontaneous cellulitis were retrospectively reviewed in Chang Gung Memorial Hospital, Kaohsiung from 1986 through 1996. We analyzed their physical conditions, clinical manifestations, and outcome. All patients received renal biopsies and had pathologic diagnoses. Results: The medical records of 17 patients were collected, 12 men and 5 women, with ages ranging from 16 to 63 years (mean 29.5 years). The pathologice disgnoses of renal biopsies included minimal change disease (13/17), membranous glomerulonephritis (2/17), meaangioproliferative glomerulonephritis (1/17) and focal/segmental glomerulosclerosis (1/17). All patients had generalized edematous state. The clinical presentations of these patients were variable. The mean serum albumin and daily urinary protein excretion were 1.28±0.64 g/dl and 8.75±5.16 g, respectively. The results of blood cultures were E. coli (3/17), Gram-negative bacilli (1/17), Streptococcus viridans (1/17). Streptococcus pneumoniae (1/17) and no growth (11/17). All patients responded to antibiotic treatment except one patient who died due to overwhelming sepsis. Conclusion: The related factors of spontaneous cellulitis in patients with nephrotic syndrome are edematous skin, hypoalbuminemia, immunosuppressive drugs and defective immunity. Our patients had accordant conditions. The prognosis was good if diagnosis and treatment are made early. |
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