INTRAVENOUS IMMUNOGLOBULIN - INDUCED OSMOTIC NEPHROSIS

被引:67
作者
AHSAN, N
PALMER, BF
WHEELER, D
GREENLEE, RG
TOTO, RD
机构
[1] UNIV TEXAS,SW MED CTR,DEPT INTERNAL MED,DIV NEPHROL,DALLAS,TX 75235
[2] UNIV TEXAS,SW MED CTR,DEPT NEUROL,DALLAS,TX 75235
[3] UNIV TEXAS,SW MED CTR,DEPT PATHOL,DALLAS,TX
关键词
D O I
10.1001/archinte.154.17.1985
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Intravenous immunoglobulin preparations are being used for an increasing number of indications in clinical medicine. To minimize adverse reactions, sugar additives such as sucrose are added to come preparations to serve as stabilizing agents. We describe a patient treated with an immunoglobulin preparation containing sucrose who developed a fully reversible form of acute renal failure with histologic changes characterized by vacuolization and swelling of renal proximal tubular cells. We believe the high concentration of sucrose in the immuno-globulin preparation resulted in osmotic injury to the renal tubules. Such changes, which are identical to those described in humans and experimental animals given intravenous infusions of hypertonic sucrose, have come to be known as osmotic nephrosis. Risk factors for the development of this lesion are renal insufficiency and volume depletion. The risk for such injury can be minimized by further diluting the immunoglobulin preparation and slowing the infusion rate.
引用
收藏
页码:1985 / 1987
页数:3
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