新医学2016，Vol.47Issue(3)：202-204,3.DOI:10.3969/j.issn.0253-9802.2016.03.017
无肝素血液碳酸液透析治疗痛风性肾病合并别嘌醇过敏综合征一例
Treatment of gouty nephropathy complicated with allopurinol hypersensitivity syndrome by bicarbonate hemodialysis:a case report
张路家 1何洁莹 1张惠丽1
作者信息
- 1. 510120 广州，广州医科大学附属第一医院肾内科
- 折叠
摘要
Abstract
The Han Chinese are susceptible to allopurinol hypersensitivity syndrome due to high posi-tive rate of HLA-B*58∶01 .The article reported an 82-year-old male patient diagnosed with gouty nephropathy complicated with allopurinol hypersensitivity syndrome.He suffered from recurrent metatarsophalangeal joint pain and hyperuricemia for over 1 0 years.In recent 1 year,the episode of gout became more and more frequent and was untreated with anti-inflammatory therapy.He presented with oxfoliative dermatitis at 7 days after allo-purinol administration in a local hospital.Upon admission to our hospital,he was diagnosed with chronic kid-ney disease (CKD 4)and hepatic function injury.Conventional xanthine oxidase inhibitors (XOI)or uricosu-ric drugs were prohibited.After hospitalization,he was administered with an adequate dose of adrenocortical hormone via intravenous route.Following active bicarbonate hemodialysis and anti-infection therapy,gout symptoms were alleviated,serum uric acid level was decreased,skin lesions were healed and liver function re-stored to normal.The diagnosis and treatment of this case hint that it is necessary to conduct screening of posi-tive HLA-B*58∶01 in the Han population when administered with allopurinol.Bicarbonate hemodialysis is an effective and safe treatment for patients who are complicated with liver and /or renal function injuries,and un-suitable for use of uricosuric drugs.关键词
血液碳酸液透析/痛风性肾病/别嘌醇过敏综合征Key words
Bicarbonate hemodialysis/Gouty nephropathy/Allopurinol hypersensitivity syndrome引用本文复制引用
张路家,何洁莹,张惠丽..无肝素血液碳酸液透析治疗痛风性肾病合并别嘌醇过敏综合征一例[J].新医学,2016,47(3):202-204,3.
