Liver failure and death after exposure to microcystins at a hemodialysis center in Brazil
Liver failure and death after exposure to microcystins at a hemodialysis center in Brazil
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DOI：
10.1056/nejm199803263381304
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发表时间：
1998-03-26
影响因子：
158.5
通讯作者：
Jarvis, WR
中科院分区：
文献类型：
--
作者：
Jochimsen, EM;Carmichael, WW;Jarvis, WR
背景血液透析是一种常见但潜在危险的手术。1996年2月17日至20日，巴西卡鲁阿鲁的一家透析中心（透析中心A）的130名患者中有116名（89%）出现与血液透析相关的视力障碍、恶心和呕吐。方法病例为1996年2月在A透析中心或Caruaru其他透析中心（透析中心B）接受透析的急性肝衰竭患者。为了确定爆发的危险因素和来源，我们对透析中心A的130名患者和透析中心B的47名患者进行了队列研究，审查了中心的供水，并收集了水，患者的血清和死后肝组织进行微囊藻毒素检测。死亡的受影响患者比幸存者年龄大（中位年龄，47岁对35岁; P
Background Hemodialysis is a common but potentially hazardous procedure. From February 17 to 20, 1996, 116 of 130 patients (89 percent) at a dialysis center (dialysis center A) in Caruaru, Brazil, had visual disturbances, nausea, and vomiting associated with hemodialysis. By March 24, 26 of the patients had died of acute liver failure.Methods A case patient was defined as any patient undergoing dialysis at dialysis center A or Caruaru's other dialysis center (dialysis center B) during February 1996 who had acute liver failure. To determine the risk factors for and the source of the outbreak, we conducted a cohort study of the 130 patients at dialysis center A and the 47 patients at dialysis center B, reviewed the centers' water supplies, and collected water, patients' serum, and postmortem liver tissue for microcystin assays.Results One hundred one patients (all at dialysis center A) met the case definition, and 50 died. Affected patients who died were older than those who survived (median age, 47 vs. 35 years; P