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はじめに
腎乳頭壊死は欧米では多数の報告例がみられるが,本邦では未だまれな疾患と思われる。以前より糖尿病,尿路感染症,尿路閉塞と関係深いことが知られており,最近では鎮痛剤の乱用(殊にフェナセチソ),鎌状赤血球症との関係も指摘されている。本邦では報告例が自験例を含めて15例しかなく,殊に鎮痛剤による腎乳頭壊死のはつきりしたものは未だその報告例がないようである。最近当教室で,鎮痛剤常用者にみられた腎乳頭壊死の1例を経験したので報告する。
A case of bilateral papillary necrosis due to analgesic abuse, was reported.
Patient was a 39 year old married female, with nothing particular in the family history but has been a habitual user of anagesic (Sedes) since 22 for hemicrania. The duration has been approximately 17 years and the total amount would be about 10 kg of Sedes which would be estimated as 4 kg as phenacetin. Patient underwent bilateral nephropexy for pyelonephritis when she was 34. She had been free from pyelonephritis ever since but started to recur time to time after 37 year old.
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