铊中毒误诊为格林-巴利综合征  

Misdiagnosis Analysis of Thallium Poisoning for Guillain-Barre Syndrome

作　　者：苌翠粉 朱钧[2] 

机构地区：[1]河北省职业病医院职业病科,石家庄050051 [2]首都医科大学附属北京朝阳医院职业病科,北京100051

出　　处：《临床误诊误治》2012年第5期1-2,共2页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨铊中毒的临床特点及误诊原因,以提高临床确诊率。方法回顾分析误诊为格林-巴利综合征的铊中毒1例的临床资料。结果患者因四肢麻木、疼痛、无力16 d,脱发6 d入院。曾于当地医院就诊,经肌电图等检查诊断为格林-巴利综合征,予糖皮质激素治疗无效,后出现大量脱发转入北京朝阳医院。经综合分析临床表现及相关医技检查结果(尿铊1650μg/L),确诊为急性铊中毒。行血液灌流结合血液透析治疗,同时给予对症支持治疗,1个月后好转出院。结论铊中毒临床较为少见,早期表现不典型,且多数患者铊接触时间及途径较为隐匿,易误诊,临床工作中应予以警惕。Objective To analyze the cause of misdiagnosis of Thallium poisoning and to discuss its clinical character- istics. Methods Retrospective analysis of clinical data of a case of Thallium poisoning misdiagnosed as Guillain-Barre syn- drome was made. Results The patient was admitted for limbs numbness and pain, weakness for sixteen days, baldness for six days. The patient had been misdiagnosed as having Guillain-Barre syndrome undertook electromyogram, and glucocorticoids treatment showed no effect. The patient was admitted into Beijing Chaoyang Hospital for a great deal of baldness. The diagnosis of Thallium poisoning was defined afler a synthesis of clinical situation and iatrical examination （ uro-thallium 1650 μg/L） after hemoperfusion with haemodialysis treatment, and heteropathy was given at the same time, and the patient recovered and was dis- charged 1 month later. Conclusion Clinically, thallium poisoning is rare with no typical manifestations in the early course of the disease. Thallium poisoning tends to be misdiagnosed, because it is difficult to find the contact time and path.

关 键 词：铊中毒 误诊 格林-巴利综合征 

分 类 号：R595.2[医药卫生—内科学]