A Case of Blue Toe Syndrome and Myonephropathic Metabolic Syndrome with Abdominal Aortic Aneurysm.
10.4326/jjcvs.23.340
- VernacularTitle:術前にＢｌｕｅ ｔｏｅ ｓｙｎｄｒｏｍｅ， Ｍｙｏｎｅｐｈｒｏｐａｔｈｉｃ ｍｅｔａｂｏｌｉｃ ｓｙｎｄｒｏｍｅ（ＭＮＭＳ）を併発したと考えられた腹部大動脈りゅう手術症例の１治験例
- Author:
Hiroshi Sato
;
Masao Okamura
;
Masayoshi Okada
;
Hitoshi Matsuda
- Publication Type:Journal Article
- Keywords:
Myonephropathic metabolic syndrome;
Blue toe syndrome
- From:Japanese Journal of Cardiovascular Surgery
1994;23(5):340-344
- CountryJapan
- Language:Japanese
-
Abstract:
A 49-year-old man presented in emergency center with complaints of severe lumbago and severe pain of the right lower limb. Symptoms were suggestive of hernia nuclei pulposi and he was referred to orthopedic department of our hospital. His pain was not relieved by analgesics and the right lower leg was cyanotic with a swollen, hard, and tender calf. On palpation a pulsating mass was revealed in the mid-abdomen. He was transferred to the cardiovascular floor. CT and IA-DSA revealed an abdominal aortic aneurysm and no occlusion of the major arteries of the right lower leg. The serum glutamic oxaloacetic, lactic dehydrogenase levels all increased especially the creatinine phosphokinase increased to 46, 460IU/l, and the urine myoglobin level was 4, 200ng/ml. Myonephropathic metabolic syndrome (MNMS) was suspected. Urine volume was maintained with fluid infusion and diuretics. The blood urea nitrogen and potassium levels remained within normal limits throughout the course. The immediate recognition of MNMS and treatment of the condition were successful in preventing serious complications. But all the toes of the right foot became necrotic and they were amputated. Two months after admission, replacement of the abdominal aortic aneurysm was performed successfully. The patient was discharged in good condition one month after the operation.
