误诊肝衰竭的不明原因横纹肌溶解所致的急性肾损伤1例

A case of acute kidney injury caused by unexplained rhabdomyolysis misdiagnosed as liver failure

  • 摘要: 横纹肌溶解是一组由于骨骼肌细胞膜完整性受损, 细胞内内容物(如肌红蛋白、肌酸激酶及电解质等)大量释放入血循环,从而引发全身性病理生理反应的临床综合征。其最常见且严重的并发症为急性肾损伤,主要由肌红蛋白在肾小管中沉积及肾缺血共同作用所致。由于早期临床表现缺乏特异性,患者常易被误诊或延误治疗,进而引起病情加重,甚至危及生命。本文报道1例以不明原因横纹肌溶解起病,并在病程中发生急性肾损伤的病例,结合其临床特征与实验室检查结果,对其潜在病因进行系统分析和探讨。

     

    Abstract: Rhabdomyolysis is a clinical syndrome characterized by damage to the integrity of skeletal muscle cell membranes, massive release of intracellular contents (such as myoglobin, creatine kinase, and electrolytes) into the bloodstream, thereby triggering systemic pathophysiological responses. Its most common and severe complication is acute kidney injury, primarily resulting from the combined effects of myoglobin deposition in renal tubules and renal ischemia. Due to lack of specific early clinical manifestations, patients are often misdiagnosed or experience delayed treatment, which can lead to exacerbation of the condition and even life-threatening consequences. This article reports a case of a patient who presented with unexplained rhabdomyolysis at onset and subsequently developed acute kidney injury during the course of the disease. A systematic analysis and discussion of the potential etiology are conducted based on the patient's clinical features and laboratory test results.

     

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