NEJM:累积肝脏的常染色体显性遗传多囊肾病-病例报道

2019-05-16 xing.T 网络

在常染色体显性多囊肾病中,囊肿可在一系列部位发生发展,包括肝脏、胰腺和精囊。该患者接受静脉补水和镇痛治疗,疼痛减轻。

患者为一名51岁的患有常染色体显性遗传性多囊肾病的妇女,因慢性腹痛轻度恶化而到初级保健诊所就诊。

体格检查未发现黄疸;肝脏扩大,患者右上腹和两侧侧腹有轻度压痛。墨菲症阴性。实验室检查显示天冬氨酸氨基转移酶和丙氨酸氨基转移酶水平略有升高。腹部超声检查发现无数囊肿;胆囊无法可视化。进行磁共振胰胆管造影并显示肝脏明显增大,有许多囊性结构(图中显示了三维最大强度-投影重建)。未发现囊内出血、破裂或感染的迹象;该表现与急性胆囊炎不一致。



在常染色体显性多囊肾病中,囊肿可在一系列部位发生发展,包括肝脏、胰腺和精囊。该患者接受静脉补水和镇痛治疗,疼痛减轻。

在1年的随访中,没有出现其他并发症或新发症状。患者仍然偶尔出现腹痛。  

原始出处:

Mehmet E. Adin,et al.Liver Involvement in Autosomal Dominant Polycystic Kidney Disease.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1809242

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    2019-05-16 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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患者女,49岁,汉族,已婚,农民。以3d前右下肢出现大片状红斑到我院皮肤科就诊收住入院。体格检查:无明显异常。实验室检查:肿瘤标记物CA72413.6U/ml,其余阴性。超声检查:肝左叶见大小约61mm×56mm实性略高回声占位,边界清晰,内部回声不均匀,CDFI:肿块周边及内部见较丰富血流信号。超声造影:造影剂注入肿块后9s呈环状且向心性轮辐样高增强,10s迅速强化,30s逐渐消退,肿块边界清晰