Correspondent Jiang Li
Xiao Zheng (pseudonym) in her 20s is in her peach and plum years. A few months ago, she came to Quzhou from the northeast, thousands of miles away, to visit relatives. One day, she suddenly felt chest tightness, shortness of breath, cough and sputum. She thought it was a cold, so she went to the nearest community service center for infusion treatment. However, a few days later, Xiao Zheng’s symptoms not only did not improve, but her chest tightness and suffocation became more serious. She came to the Department of Internal Medicine of the Second People’s Hospital of Quzhou City (Quzhou Second Hospital).
Relevant examination results showed that Xiao Zheng’s serum potassium was 6.50 mmol/L, and his serum creatinine, liver enzymes, and muscle enzymes all reached thousands of values… The outpatient doctor immediately arranged Xiao Zheng to be hospitalized. Due to his serious condition, the results of various examinations were not optimistic, and Xiao Zheng was admitted to the intensive care unit (ICU).
After entering the ICU, Xiao Zheng finally confided the truth in the face of meticulous inquiries, physical examinations and various life support equipment he had never seen before. It turned out that she suffered from systemic lupus erythematosus and lupus nephritis for more than 10 years. Before coming to Quzhou, she had been taking medicine regularly, and her condition was still under control. In recent months, Xiao Zheng has completely forgotten that he is a patient and forgot to take medicine. These days, he has chest tightness and rarely urinating. At the same time, reports of critical values of various bedside tests followed. Obviously, Xiao Zheng developed severe infection, multiple organ failure, and severe hyperkalemia. Every critical value may cost Xiao Zheng’s life in minutes! Antibiotics, cardioactive hormones, human serum albumin, continuous renal replacement therapy at the bedside, blood transfusions… After each doctor’s order was issued, medical staff raced against time to win new life for them. Subsequently, the Department of Critical Care Medicine convened a multidisciplinary consultation such as the Department of Rheumatology and Nephrology. The resident expert of the Department of Rheumatism and Immunology of the Second Affiliated Hospital of Zhejiang University School of Medicine and Li Yanbiao, director of the Department of Rheumatism and Immunology of the Second Affiliated Hospital of Quzhou, jointly consulted to formulate a treatment plan for Xiao Zheng.
One week later, Xiao Zheng’s chest tightness improved, and the inflammation and liver function indicators improved significantly. After Li Yanbiao’s re-consultation, he was transferred to the Rheumatology and Immunology ward for further treatment.
Coincidentally, the doctor on duty in the Rheumatology and Immunology Department was Dr. Shao Dehong, who also came from the northeast a few months ago. Hearing the familiar local accent, Xiao Zheng felt kindly and said with emotion: “I didn’t expect to be able to do it here. I met a fellow!” After asking about his medical history again, Dr. Shao Dehong was pleasantly surprised to find that Xiao Zheng had always been a patient of his postgraduate tutor. After the condition improved, Xiao Zheng asked to go back to his hometown to continue treatment. Taking into account the patient’s safety, the long distance and many other factors, the medical staff of the Rheumatology and Immunology Department calculated many days in advance whether the patient’s hormones could be reduced to oral doses as planned, whether they could insist on returning to the local area to continue hemodialysis, and whether they could go on On the way back home, the temporary hemodialysis tube was successfully removed. The medical staff also contacted the rheumatologist at the local hospital in advance to help the patient receive follow-up treatment as smoothly and safely as possible.
Many people have heard of “systemic lupus erythematosus (SLE)”, the most representative autoimmune disease of unknown etiology, commonly seen in young women. Mild cases manifested as arthralgia, hair loss, and rash, while severe cases involved blood system, kidneys, heart, lungs, liver and other organs. Failure to receive timely and effective treatment will significantly increase the risk of death of patients.
Li Yanbiao reminded that if the patient has symptoms such as rash and joint pain, he should seek medical attention as soon as possible; Basic examination of liver and kidney function, immune globulin and complement can detect disease recurrence and adjust treatment in time.