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증례 : 신장 ; 일산화탄소 중독 후 동시에 발생한 급성 신손상과 횡문근융해증 1예
노신영 ( Sin Young Nho ),이인희 ( In Hee Lee ),안기성 ( Ki Sung Ahn ),현대성 ( Dae Seong Hyeon ),강건우 ( Gun Woo Kang ) 대한내과학회 2015 대한내과학회지 Vol.89 No.4
일산화탄소 중독 후 급성 신손상 및 횡문근 융해증이 동시에 발생한 예는 매우 드물게 보고되고 있다. 이에 저자 등은 자살 목적으로 연탄가스 흡입 후 일산화탄소 중독과 관련된 급성 신손상 및 횡문근융해증으로 진단하였고 고압산소치료 없이 고농도 산소 및 보존적 치료만으로 호전된 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Carbon monoxide (CO) poisoning has increased rapidly in South Korea and may cause a variety of clinical effects. The most common complications are neurologic and neuropsychological disturbances. However, in rare cases, CO poisoning may also be associated with acute kidney injury and non-traumatic rhabdomyolysis. Here, we report a case of acute kidney injury and rhabdomyolysis complicating CO poisoning. A 32-year-old woman was admitted to our emergency department with dyspnea and confused consciousness after exposure to CO during a suicide attempt involving charcoal briquettes. Laboratory findings revealed a carboxyhemoglobin (COHb) level of 44.8%, a blood urea nitrogen level of 20.5 mg/dL, a serum creatinine level of 1.4 mg/dL, and a creatine phosphokinase level of 8,688.3 IU/L. Acute kidney injury and rhabdomyolysis complicating CO poisoning were diagnosed. This case was managed with normobaric oxygen therapy and hydration. The patient recovered completely with respect to renal function and muscle enzyme level, and COHb level returned to 0%. (Korean J Med 2015;89:461-464)
홍창우 ( Chang Woo Hong ),노신영 ( Sin Young Nho ),이인희 ( In Hee Lee ),안기성 ( Ki Sung Ahn ),박관규 ( Kwan Kyu Park ),강건우 ( Gun Woo Kang ) 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Ethambutol is commonly used as a first-line drug for the treatment of tuberculosis. The most serious adverse effect of ethambutol therapy is optic neuropathy. However, ethambutol-induced acute kidney injury is extremely rare. We report herein a case of acute kidney injury secondary to ethambutol-associated acute interstitial nephritis. A 65-year-old man with pulmonary tuberculosis presented with a > 7-day history of nausea and vomiting. He had begun antituberculosis medications including ethambutol 3 weeks previously. His laboratory findings showed elevated blood urea nitrogen and serum creatinine levels (32.6 and 3.6 mg/dL, respectively). Examination of percutaneous renal biopsy specimens showed diffuse interstitial mononuclear cell infiltration with mild interstitial edema. The patient was treated by cessation of ethambutol and supportive care. His renal function completely recovered (creatinine, 1.1 mg/dL) and his clinical symptoms improved. (Korean J Med 2014;87:352-356)