NEJM: 胃肠血吸虫病致泌尿系钙化-案例报道

2016-02-25 chenshuo译 MedSci原创

http://www.nejm.org/doi/full/10.1056/NEJMicm1504759

男性,43岁,因出现排尿困难及间歇性血尿史1月余而入院就诊。


据该男子主诉,在过往的6个月中,类似的症状也曾发生过多次,同时还伴有直肠出血的现象。
常规体格检查,未见异常。



抽血化验结果显示白蛋白肌酐比值升高(96mg/mol),尿检中可见畸形红细胞存在。尿培养未发现细菌感染。血清血吸虫抗体效价为1:256。肾脏超声检查显示轻度肾积水。腹部和骨盆CT平扫显示右肾输尿管水肿,隐约可见轻度的输尿管壁钙化(如图A,白色箭头处)和膀胱平滑壁钙化(如图A,B,和C,黄色箭头处)。同时,结果还显示精囊钙化(如图B,红色箭头处)和直肠乙状结肠肠壁钙化(如图B和C,白色箭头处)。

对于本案例中的患者出现腹部及盆腔部多部位多器官的钙化,属于典型的慢性泌尿系统钙化及胃肠血吸虫病,其中血吸虫幼虫的沉积是器官壁是钙化的主要原因。

该患者的诊断主要是根据其以往的接触史,和显著的临床症状及影像学表现。由于肺结核也可引起膀胱壁钙化,因此,也应考虑鉴别诊断。

原始出处:

Pankaj Nepal, M.D., and Devendra Kumar, M.D.Eggshell Calcifications of the Bladder N Engl J Med 2016;9 February 25, 


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    2016-03-16 DoctorTao1991

    一个case 还能打这么高分的杂志 666

    0

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    2016-02-26 ylz8404
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