A 24 -year -old nurse in Xiaoshan has a sudden stroke and abdominal pain for more than a month of pregnancy. Abdominal pain will also "walk" around the abdomen. After stroke surgery, symptomatically treats pain, abdominal pain has not been relieved, and even abnormal behavior, spiritual spirit, spiritConfused.
Eat bad?Stimulated?After all kinds of guess, the doctor put her urine in the sun and exposed for 4 hours, and the urine turned into brown, which was confirmed to be pyrine. This is also called vampires. The patient was afraid of the sun.sick.
Recently, Zhou Jiancang, Wang Feng, and Dr. Wang Feng, and Dr. Wang Feng, and Dr. Wang Feng, and Dr. Jin Dan of Zhejiang University Medical College organized and analyzed the diagnosis and treatment process of this case, and will soon be published in the magazine of professional journals.
After the reporter learned, I also wanted to tell you this story. One was that the case was too strange. In the past, there were almost only textbooks, and the other wanted to give a praise for the doctor. The process of identifying the diagnosis and treatment was like a detective.
Pregnant women have a sudden stroke, accompanied by traveling abdominal pain
The medication cannot be relieved, the cause is suspicious
Time is going to return to last April. Ms. Wang (pseudonym) transferred from Xiaoshan to the emergency department of Qingchun Hospital of Shao Yifu Hospital. When she was delivered, people were unconscious.
Dr. Wang Feng described that female patients look handsome, 1.6 meters tall, are not very fat, and they are very young. Theoretically, it is not a high -risk group of stroke.At that time, a series of examinations were diagnosed clearly that intracranial hemorrhage was about 30ml, and the situation was urgent. The neurosurgery immediately performed craniotomy for her to remove the hematoma.
Patient’s right top pillow lobe cerebral bleeding
Subsequently, Ms. Wang was sent to the ICU for treatment. After 2 days, she woke up. The initial consciousness was awake, but soon, a series of abnormal performance and behavior gradually appeared.
One is intermittent temperament changes.She would be quiet all at once, looking around, emotional excitement, hitting the bed hard, murdering in her mouth, and even shouting, but she couldn’t hear what was saying.
ICU’s medical care is very distressed. After all, this is a pregnant woman who has been pregnant for 2 months. Because of the stroke of the brain, she undergone CT examination and surgery.But at the same time, they doubts about Ms. Wang’s abnormal behavior and mental chaos.
The other is constantly shouting abdominal pain, which is belonging to abdominal colic. It has a occasion for a while. Sometimes the pain is above, sometimes below, the left and right sides will also occur, and abdominal pain seems to be "walking".ease.
I have eaten seafood 9 days before the onset
Previous pregnancy also appeared abnormal behavior and mental confusion
Such an unprecedented manifestation, especially walking in abdominal pain, is very rare in the past. How to solve it?Ms. Wang’s supervisor Zhou Jiancang, Wang Feng, and Jin Dan decided to find the cause of "two roads".
At this end, please digest the Department of Gastrointestinal Division, the chief physician of the Department of Gastrointestinal, and check whether Ms. Wang has cholecystitis or other gastrointestinal diseases.It is regrettable that no obvious abnormal abnormalities were found in gastric and colonoscopy and abdomen CT.
On the other hand, they asked their family members to talk and wanted to ask them carefully to find clues from the diet and living habits before the patient’s onset.She was accompanied by her mother and husband in the hospital for treatment. The two provided two clues.
Nine days before the onset, Ms. Wang had eaten seafood, mainly shells and shrimp. The lower abdomen colic appeared at night, about half an hour, and vomiting and diarrhea.
Ms. Wang was a nurse in a hospital in Xiaoshan. She had a strong medical knowledge. She looked at the expert clinic at the unit as soon as she went to work the next day. She hung her salt water for a few days.On the 7th day, she was chatting with her husband in the bed. Suddenly, the stroke was unconscious. Due to her illness and fierceness, she was immediately transferred to Shao Yifu Hospital.
Husband said that this was the second pregnancy of Ms. Wang. About a year ago, she had an ectopic pregnancy. After pregnancy, she had hallucinations.There are birds flying over, and the expression is strange.
If you eat seafood badly, it should be gastroenteritis, and abdominal pain will not "walk away"!Two pregnancy, both mental abnormalities, how to explain?The diagnosis was in a deadlock.
Multi -disciplinary consultation, suspected that it is vampire
The dramatic plot staged in American dramas appears in reality
Faced with multiple doubts, with the coordination of the medical department, Pan Konghan, director of the ICU, organized a multi -disciplinary discussion of Shawiyi Hospital. Neurosurgery, neurology, digestive department, general surgery, ICU, endocrinology, and psychiatry were complete.In a conference room, Wuwu took a large group of experts, and everyone expressed their opinions.
"Will it be a problem in the gastrointestinal tract, a rare type?" "Make a mental condition further?" During the fierce discussion, a new news became a turning point -the night before the consultation, Ms. Wang’s mother’s motherInadvertently mentioned a detail, the daughter was particularly afraid of the sun from an early age. If she went out without an umbrella on a sunny day, it was easy to be sunburned, blisters or itching, especially torture.
Medically, this manifestation is called light sensitivity.Light sensitivity, mental abnormalities, and walking abdominal pain, combining these three characteristics, will it be pheasin disease?
Everyone looked at each other.This disease almost exists in textbooks, and has never been encountered in reality.Polyrine is also called vampires. Patients are afraid of the sun. It is rare. The incidence is only one in 50,000 or even lower. Women are more than men.At present, there are no more than 500 patients in the world.
In "Intern Grace", the patient was misdiagnosed as a cholecystitis. Finally, an intern was diagnosed with a clue of red urine and diagnosed.One of the patients in "Doctor of the Night Class" was misdiagnosed for a long time, and the diagnosis was clearly diagnosed in the urethral dodification bag.
Is it the plot in American dramas and the real performance in reality?
After the exposure of the urine, the "real murderer" emerged
Clear relatives get married and have children, her daughter has genetic variations
A experiment for the truth was staged in the ICU.The doctor took 2 small cups of urine for Ms. Wang, put a cup of bed, put a cup on the window sill, let the sun exposure, and then compare with the urine of normal people.After 4 hours, the exposed urine became brown."Such an experiment has initially proved that the cause should be aerrine disease. The subsequent genetic testing found that the patient had a lack of gene site, which proved this conclusion." Dr. Wang Feng said.
Anthhin disease is a kind of ingredients with sexual genetic diseases that often exist in family history.When the doctor and Ms. Wang’s family conveyed this information, the mother who had always been positive and urgent to care about her daughter’s condition in the past suddenly silently silent.
After a long time of silence and hesitation, the mother said that she was a cousin and sister with her husband. She was married to close relatives. She gave birth to such a daughter. I did not expect her daughter to have genetic mutations.
The story has developed here, the truth is white, and a series of diseases and symptoms are all spoken.
Dr. Wang Feng explained that the incentives of pyrine disease include menstruation, pregnancy, drugs (such as Babi, sulfa, estrogen, etc.), insufficient calorie intake and infection."Ms. Wang’s onset this time, and the mental abnormalities of the last pregnancy, suspected that it may be related to excessive secretion of estrogen secretion after pregnancy."
Ms. Wang’s condition was quickly controlled by the cause of the cause of the cause, coupled with the end of pregnancy and the clear palace surgery. After just two days, she moved from ICU to the general ward, and was discharged smoothly.
Two days ago, the ICU nurse of Shaw Run Hospital was discharged from the hospital.Ms. Wang was lamented on the phone. After listening to the family about the entire diagnosis and treatment process, she was too like a detective. Thanks to the doctor for letting herself reborn.
1. Why is pyromolin disease called vampires?
Polyrine is a kind of light -sensitive pigment. Most of the pyrine is benign in the light and does not cause life harm to the body. Once the sun is exposed to the sun, it will be converted into dangerous toxins. If the skin is affected, blisters or itching will occur in the sunlight.You can only live in the dark world, fear of the sun, which may be the origin of the vampire story.
The earliest connection with vampire and hemorrin disease was the Canadian chemist David Dorin. He saw that hemoglobin input hemoglobin when he heminoline disease was needed., To relieve symptoms.
Of course, this has been rumored by the doctor.Although blood transfusion is an effective means to rescue patients with severe hemorrine disease, there is no medical basis for drinking blood for blood treatment. Some delayed skin type hemorride disease even need to regularly bleed from vein to reduce symptoms.
2. What are the symptoms and characteristics of chloride disease?
The clinical manifestations of pheasin diseases mainly include three major categories: abdominal symptoms, neurological symptoms, and skin damage. In severe cases, they can cause respiratory muscle paralysis and die. The mechanism is not completely clear.It is related to the toxic effect brought by the gallbladder.
Symptoms can last for several hours, days or weeks or longer.Abdominal pain is the most common and earliest symptoms. 85%to 95%of patients have abdominal pain during acute seizures. Most of the severe, persistent, and position are not fixed. Sometimes they have similar acute intestinal obstruction such as constipation, bloating, and vomiting.
In addition, the treatment of acute porphyrine diseases will require patients to consume high sugar diets, reduce pyrine production, and prevent the onset of pyrodoline disease.
3. How to detect early treatment early?
Acute intermittent intermittent phenein disease is an ingredient inheritance. The probability of 50%of the relatives of the straightforward relatives has this mutation, and then 50%of the probability of passing suspected pathogenic genes to its children. Genetic detection can clearly mutate genes and typeNot only can patients be treated in a timely manner, but also members of the high -risk family can also screen routinely to give corresponding genetic consultations.
For abdominal pain that is not explained in clinical practice, it is accompanied by mental symptoms and neurological symptoms, and at the same time, there is anemia, abnormal liver function, light aversion, and skin damage.After the exposure, the color deepening experiments are simple and easy, and important screening information can be provided in a short time.