SEIZURES RELATED TO BLOOD-TRANSFUSION AND ERYTHROPOIETIN TREATMENT IN PATIENTS UNDERGOING DIALYSIS
SEIZURES RELATED TO BLOOD-TRANSFUSION AND ERYTHROPOIETIN TREATMENT IN PATIENTS UNDERGOING DIALYSIS
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DOI：
10.1136/bmj.299.6710.1258
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发表时间：
1989-11-18
影响因子：
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通讯作者：
RAINE, AEG
中科院分区：
文献类型：
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作者：
BROWN, AL;TUCKER, B;RAINE, AEG
重组人促红细胞生成素对慢性肾衰竭贫血的纠正导致堆积细胞体积的增加，从而导致血液粘度的增加，易导致血管阻力增加和高血压的发展。到目前为止，在接受促红细胞生成素治疗的患者中，几乎有一半患者出现血压升高，但更令人担忧的是，在英国，其中7例患者出现癫痫发作。2尽管这些症状与高血压性脑病相似，但其机制尚不清楚。据报道，我们的一位患者在接受促红细胞生成素治疗后癫痫发作。我们在这里描述了一个病人输血后11天的癫痫发作，以及一个接受连续动态腹膜透析的无肾病人的两次类似发作。这些发作是令人感兴趣的，因为它们与促红细胞生成素治疗相关的癫痫发作相似。一例52岁白人女性慢性肾小球肾炎患者自1973年以来一直接受血液透析治疗。1987年11月，她的促红细胞生成素试验结束后，她再次依赖输血。1988年4月28日输血后，她的血压从140/75上升到180/90毫米汞柱
Correction of the anaemia of chronic renal failure by recombinant human erythropoietin results in a rise in packed cell volume with a consequent increase in blood viscosity, predisposing to increased vascular resistance and the development of hypertension. Increases in blood pressure have occurred in almost half the patients treated so far with erythropoietin,'but ofmore serious concern is the development of seizures in seven of these patients in the United Kingdom. 2 Although these bear similarities to hypertensive encephalopathy, their mechanism remains unclear. An episode of seizures associated with erythropoietin treatment in one of our patients has been reported. We describe here a subsequent seizure suffered by this patient 11 days after a blood transfusion and two similar episodes suffered by an anephric patient undergoing continuous ambulatory peritoneal dialysis. These episodes are of interest because of their resemblance to the seizures reported in association with erythropoietin treatment.Case 1 A 52 year old white woman with chronicglomerulonephritis had been maintained on haemodialysis since 1973. After her trial of erythropoietin ended in November 1987 she again became dependent on blood transfusions. After transfusion on 28 April 1988 her blood pressure increased from 140/75 to 180/90 mm Hg