朱砂莲中毒致急性马兜铃酸肾病

Acute aristolochic acid nephropathy due to kaempfer dutchmanspipe root poisoning

1名73岁女性患者,因胃部不适服用朱砂莲粉末约20g,10min后出现持续呕吐,经对症治疗未缓解。3d后出现少尿,尿常规显示:pH9.0,Glu(+),PRO(┼┼),KET(+)。BUN17.8mmol/L,SCr708μmol/L,UA294.5μmol/L。B超显示双肾弥漫性实质病变。诊断为朱砂莲中毒所致的急性马兜铃酸肾病、急性肾衰竭。给予金水宝胶囊、多巴胺、呋塞米、碳酸氢钠、氢化可的松等治疗及血液透析,患者尿量逐渐增多,肾功能改善,症状消失。3个月后随访,肾功能稳定。

A 73-year-old woman took about 20 g of kaemfer dutchmanpipe root powder for treating stomach discomfort. Ten minutes later, she developed vomiting. She did not resolve Despite symptomatic therapy. Three days later, she developed oliguria. A routine urine test revealed the following values： pH 9.0, Glu （ ＋ ）, PRO （-m-）, and KET （ ＋ ）, She had a BUN level of 17.8 mmol/L, a SCr level of 708 μmol/L, and a UA level of 294.5 μmol/L. A B-ultrasonography showed diffused parenchymatous lesions in the kidneys. She was diagnosed with acute aristolochic acid nephropathy and acute renal failure due to kaempfer dutchmanspipe root poisoning. After treatment with Jinshuibao capsules, dopamine, furosemide, sodium bicarbonate, hydrocortisone, and hemodialysis, the patients urine volume gradually increased , Her renal function improved and the symptoms disappeared. At follow-up 3 months later, her renal function remained stable.