透析相关性淀粉样变  

Dialysis related amyloidosis

作　　者：董建华 黄力 涂远茂 葛永纯 DONG Jianhua;HUANG li;TU yuanmao;GE Yongchun(National Clinical Research Center of Kidney Diseases,Jinling Hospital,Nanjing University School of Medicine,Nanjing 210016,China)

机构地区：[1]东部战区总医院,国家肾脏疾病临床研究中心,全军肾脏病研究所,南京210016

出　　处：《肾脏病与透析肾移植杂志》2020年第5期494-498,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：65岁男性患者,维持性血液透析34年,近3年出现右手拇指、食指、中指及环指桡半侧麻木伴刺痛,大鱼际肌萎缩,血β2微球蛋白高,神经传导速度示正中神经损伤,MRI示腕骨多发囊性病变、关节腔内滑膜增厚,诊断为腕管综合征,行腕管松解术,腕横韧带刚果红染色阳性、免疫组化β2微球蛋白阳性,最终诊断为透析相关性淀粉样变。A 65-year-old male patient treated with maintenance hemodialysis for 34 years.He presented with pain and numbness in the first three fingers(thumb,index,middle and half of the ring)of right hand,atrophy of the thenar eminence muscles and high levels of β2-microglobulins.Nerve conduction studies conformed median nerve damage.MRI indiated multiple cystic changes in carpal bone with intraarticular synovial thickening.Carpal tunnel syndrome(CTS)is considered,surgical decompression of carpal tunnel is offered to patient.Congo red staining and immunohistochemica analysis were positive for β2-microglobulins of transverse carpal ligament.The final diagnosis was dialysis-related amyloidosis(DRA).

关 键 词：血液透析 Β2微球蛋白 腕管综合征 透析相关性淀粉样变 

分 类 号：R692.5[医药卫生—泌尿科学]