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Posterior Reversible Encephalopathy Syndrome during Recovery from Acute Kidney Injury after Hepatitis A Infection

机译:甲型肝炎感染后急性肾损伤恢复期间的后可逆性脑病综合征

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摘要

The patient was a 25-year-old healthy male who experienced fever, chills, and abdominal pain for 5 days prior to the hospital visit. He was diagnosed with acute hepatitis A, and at admission he presented with anuric acute kidney injury and hepatic encephalopathy. He received continuous renal replacement therapy followed by intermittent regular hemodialysis. His urine output increased to 1,610 ml/day after 31 days. On day 32, he suddenly developed a headache and visual disturbance and experienced three short convulsions, which were followed by postictal confusion and high fever. T2 and FLAIR MRI images of the brain revealed hyperintense signal alterations in bilateral subcortical regions of the temporoparietal and occipital lobes, consistent with posterior reversible encephalopathy syndrome. His mental status was fully recovered after 7 h of conservative treatment, including antihypertensive therapy. On hospital day 56, the renal function of the patient had recovered, and he was discharged without neurologic sequelae.
机译:该患者是一名25岁健康男性,在医院就诊前5天出现发烧,发冷和腹痛。他被诊断出患有急性甲型肝炎,入院时表现为无尿性急性肾损伤和肝性脑病。他接受了连续的肾脏替代治疗,随后进行了定期的定期血液透析。 31天后,他的尿量增加到1,610 ml /天。在第32天,他突然出现头痛和视力障碍,并经历了3次短暂的抽搐,随后出现姿势混乱和高烧。大脑的T2和FLAIR MRI图像显示颞颞顶和枕叶的双皮质下区域的高强度信号改变,与后可逆性脑病综合征一致。保守治疗(包括降压治疗)7小时后,他的精神状态已完全恢复。在住院第56天,患者的肾功能已经恢复,并且他出院时没有神经系统后遗症。

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