吗替麦考酚酯致移植肾失功的血液透析患者难治性贫血1例及文献复习

Refractory renal anemia in hemodialysis patients with renal transplantation dysfunction caused by mycophenolate mofetil:a case report and literature review

目的研究分析维持性血液透析患者出现难治性贫血的病因、临床特点和治疗方法。方法结合相关文献分析移植肾失功的血液透析患者的临床特点、实验室检查结果和病理资料,明确难治性贫血的病因。结果结合患者相关病史、实验室检查,以及骨髓细胞学检查和骨髓活检诊断为吗替麦考酚酯(MMF)所致的难治性贫血。结论MMF及代谢产物在肾衰竭患者中排泄减少,导致骨髓抑制及贫血难以纠正,正确诊断和规范治疗是纠正难治性贫血的有效手段。

Objective To study and analyze the etiology,clinical characteristics and treatment method of refractory anemia in maintenance hemodialysis patients.Methods The clinical characteristics,laboratory examination results and pathological data of a hemodialysis patient with renal transplantation dysfunction were analyzed by combining with relevant literature.Results By combining with relevant medical history,laboratory examination,bone marrow cytological examination and bone marrow biopsy,the patient was diagnosed as refractory anemia caused by mycophenolate mofetil(MMF).Conclusion The excretion of MMF and its metabolic products in the patients with renal failure is decreased,which results in the bone marrow suppression and anemia difficult to be corrected.Correct diagnosis and standardized treatment are the effective means to correct refractory anemia.