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相關文獻
- Early Recognition of Unsuspected Malignant Hyperthermia and Successful Management of Severe Myoglobinuric Renal Failure in Subsequent Rhabdomyolysis: A Case Report
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題名 | Early Recognition of Unsuspected Malignant Hyperthermia and Successful Management of Severe Myoglobinuric Renal Failure in Subsequent Rhabdomyolysis: A Case Report=早期診斷惡性高溫症與成功治療後續橫紋肌溶解症引發之急性腎衰竭:一例報告 |
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作者 | 李志雄; 林景坤; 馮仕端; 李建德; 許國泰; | 書刊名 | 長庚醫學 |
卷期 | 21:2 1998.06[民87.06] |
頁次 | 頁211-216 |
分類號 | 415.815 |
關鍵詞 | 惡性高溫症; 橫紋肌溶解症; 急性腎衰竭; Malignant hyperthermia; Rhabdomyolysis; Myoglobinuric renal failure; |
語文 | 英文(English) |
中文摘要 | 惡性高溫症是一個罕見的遺傳性肌肉疾病,其發生率約1/10000~1/50000,基因突 變的位置位在第19對染色體,遺傳形式是體染色顯性遺傳。惡性高溫症最常由某些特定的 全身性麻醉劑所誘發,橫紋肌溶解症與急性腎衰竭是其中最嚴重的併發症之一。由於惡性高 溫症與後續橫紋肌溶解症之少見,我們報告一個20歲年輕男學生,因為手汗症接受第二、 第三胸椎交感神經切除術,於全身麻醉術程中發生惡性高溫症合併橫紋肌溶解症和嚴重腎衰 竭,經由積極輸液治療,輔以2次傳統性血液透析,其腎臟功能在18天後完全恢復正常的 例子,藉以強調針對此類罕見疾病,臨床上必須保持高度警覺,以求早期診斷與投予適當治 療的重要性。 |
英文摘要 | Malignant hyperthermia (MH) is a rare inherited disorder of skeletal muscle, its inheritance being autosomal dominant and its mutant gene located on chromosome 19. MH is occasionally observed during general anesthesia when using some special triggering agents. In the susceptible patient, it presents with a fulminant skeletal muscle hypermetabolic crisis and proceeds to severe rhabdomyolysis. Once rhabdomyolysis is established, acute renal failure is not an inevitable consequence, yet it is the fatal complication if the condition is not appropriately managed. We describe a case of acute renal failure in the setting of rhabdomyolysis in unsuspected MH, resulting in full recovery after intermittent hemodialysis. In this case, we emphasize the importance of early recognition of MH and the favorable prognosis of subsequent myoglobinuric renal failure if treated appropriately. |
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