Acute abrin poisoning treated with continuous renal replacement therapy and hemoperfusion successfully: A case report.
Acute abrin poisoning treated with continuous renal replacement therapy and hemoperfusion successfully: A case report.
复制标题
连续肾脏替代治疗及血液灌流成功救治急性相思豆中毒一例报告
DOI：
10.1097/md.0000000000007423
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发表时间：
2017-07
期刊：
影响因子：
1.6
通讯作者：
Gong X
中科院分区：
文献类型：
--
作者：
Huang J;Zhang W;Li X;Feng S;Ye G;Wei H;Gong X
鸡骨草是从鸡骨草种子中提取的一种高毒性蛋白质，但在中国因摄入鸡骨草而中毒的情况极为罕见。患者女，16岁，既往身体健康，因故意误食10粒粉碎后的A precatorius种子，多次出现嗜睡、精神焦虑、呕吐、腹痛、腹泻、便血、血尿等症状，入院消化内科。急性相思豆毒素中毒。我们立即采取了有效的措施，包括洗胃、通胃、质子泵抑制剂（PPI）抑制胃酸、保肝、止血、血容量和电解质复苏、连续性肾脏替代治疗（CRRT）和血液灌流（HP）。她不适的精神状态得到改善，她变得清醒和放松。呕吐、腹痛、腹泻、便血、血尿等症状逐渐消失。女孩最终恢复良好，在3个月的随访中没有并发症。CRRT联合HP是目前尚无特效解毒剂的相思豆毒素中毒的有效治疗措施。这是第一例通过CRRT加HP成功治疗相思豆毒素中毒患者的报告病例。本研究之经验，可供临床医师在处理急性相思豆毒素中毒病患时参考。
Abrin is a highly toxic protein obtained from the seeds of Abrus precatorius, but poisoning due to ingestion of A precatorius is extremely rare in China. A 16-year-old girl, perfectly healthy before, was admitted to the department of gastroenterology owing to intentional ingestion of 10 crushed A precatorius seeds, with multiple episodes of somnolent and anxious mental status, vomiting, abdominal pain, diarrhea, hematochezia, and hematuria. Acute abrin poisoning. We immediately took effective measures including gastric lavage, purgation, gastric acid suppression by proton pump inhibitor (PPI), liver protection, hemostasis, blood volume and electrolytes resuscitation, continuous renal replacement therapy (CRRT), and hemoperfusion (HP). Her unwell mental status was improved to the point at which she became conscious and relaxed. The symptoms of vomiting, abdominal pain, diarrhea, hematochezia, and hematuria disappeared gradually. The girl eventually made an excellent recovery with no complications at her 3-month follow-up. The combination of CRRT and HP is an efficient measure in the treatment of abrin poisoning for which there is no specific antidote. This is the first reported case of an abrin poisoning patient successfully treated by CRRT plus HP. Our experience will be useful to other physicians in managing patients of acute abrin poisoning in the future.