RESUMO
Chinese herbal medicine is widely used globally. In many instances, it is associated with severe adverse outcomes. We report case of a Chinese herbal nephropathy occurring in a 43-year-old woman showing renal impairment, metabolic acidosis, Stokes - Adams syndrome, hypernatremia, and hypokalemia, characteristics not usually encountered in published cases.
Assuntos
Acidose/induzido quimicamente , Síndrome de Adams-Stokes/induzido quimicamente , Medicamentos de Ervas Chinesas/efeitos adversos , Fármacos para a Fertilidade Feminina/efeitos adversos , Hipernatremia/induzido quimicamente , Hipopotassemia/induzido quimicamente , Nefropatias/induzido quimicamente , Rim/efeitos dos fármacos , Acidose/diagnóstico , Acidose/fisiopatologia , Acidose/terapia , Síndrome de Adams-Stokes/diagnóstico , Síndrome de Adams-Stokes/fisiopatologia , Síndrome de Adams-Stokes/terapia , Adulto , Feminino , Humanos , Hipernatremia/diagnóstico , Hipernatremia/fisiopatologia , Hipernatremia/terapia , Hipopotassemia/diagnóstico , Hipopotassemia/fisiopatologia , Hipopotassemia/terapia , Rim/fisiopatologia , Nefropatias/diagnóstico , Nefropatias/fisiopatologia , Nefropatias/terapia , Resultado do TratamentoRESUMO
BACKGROUND: The repolarization properties of the crista terminalis (CT) cells have not been elucidated in patients with sinus node disease (SND). In the present study a new technique of recording the monophasic action potential (MAP) at the CT was used to examine the repolarization of the right atrium (RA) in SND patients. METHODS AND RESULTS: Symptomatic SND (n=13) patients and age-, sex-matched control patients (n=13) were tested. The MAP duration (MAPD) at a basic cycle length of 600 ms was recorded at the CT in the superior vena cava - RA junction and at the middle - anterior RA with the effective refractory period (ERP) at the high RA. In 6 controls and 4 SND patients, the effect of adenosine triphosphate on the MAPD was examined. The MAPD at the CT exceeded that at the middle - anterior RA in both groups. The MAPD at the CT in the SND group was significantly prolonged compared with the control group (CT: 358+/-39 ms vs 289+/-43 ms). Between the SND and control groups, the MAPD at the middle - anterior RA (278+/-36 ms vs 265+/-39 ms) and ERP (294+/-42 ms vs 266+/-41 ms) did not differ. Both the corrected-sinus node recovery time and sinoatrial conduction time were better correlated with the MAPD at the CT than the MAPD at the middle - anterior RA and ERP. Adenosine triphosphate shortened the MAPD, which was augmented at the CT in the SND patients. CONCLUSION: A novel method of estimating the MAP at the CT revealed the characteristics of atrial repolarization in SND patients.