Abstract：
Introduction. Contrast Induced Encephalopathy (CIE) belongs to Major Adverse Renal and Cardiovascular Events (MARCE) after iodinated contrast medium (IOCM), especially for high-risk patients with several comorbidities such as hypertension, diabetes, heart failure, and Chronic Kidney Disease (CKD). We report a case of CIE in a Peritoneal Dialysis (PD)-patient. Case report. A 78-year-old, affected by diabetes, hypertension, chronic heart failure, and End Stage Renal Disease (ESRD) treated with PD, underwent a carotid Percutaneous Angioplasty (PTA). Immediately after the exam, he developed mental confusion and aphasia. Encephalic CT scan and MRI excluded acute ischemia or hemorrhage but showed cerebral oedema. Mannitol and steroids were administered and additional PD exchange was performed with depurative aim. Within 2 days the patient completely recovered. Discussion. CIE mimics severe neurological diseases. It should be considered as a differential diagnosis if symptoms occur immediately after administration of IOCM, especially in high-risk patients and in case of intra-arterial injection. Clinical presentation includes transient cortical blindness, aphasia, focal neurological defects, and confusion. CIE is often a diagnosis of exclusion, and imaging plays a significant role. Symptoms generally resolve spontaneously within 24-48h, rarely in few days. Symptomatic therapy, including mannitol and steroids could be considered. In literature, CIE is reported only in a few patients affected by ESRD treated with chronic HD, and our is the first available case of a patient treated with chronic PD who developed this rare complication.
摘要：
Introduction.造影剂诱导性脑病（CIE）属于碘化造影剂（IOCM）后的主要不良肾脏和心血管事件（MARCE），特别是对于有多种合并症如高血压的高危患者，糖尿病,心力衰竭,慢性肾脏病（CKD）。我们报告了一例腹膜透析（PD）患者的CIE病例。病例报告。一个78岁的老人,受糖尿病影响,高血压,慢性心力衰竭,和终末期肾病（ESRD）用PD治疗，行颈动脉经皮血管成形术（PTA）。考试结束后，他出现了精神错乱和失语症。头颅CT扫描和MRI排除急性缺血或出血，但显示脑水肿。给予甘露醇和类固醇，并以净化目的进行额外的PD交换。2天内，患者完全康复。讨论。CIE模拟严重的神经系统疾病。如果在服用IOCM后立即出现症状，则应将其视为鉴别诊断，特别是在高风险患者和动脉内注射的情况下。临床表现包括短暂性皮质盲,失语症,局灶性神经缺陷,和困惑。CIE通常是一种排除性诊断，和成像起着重要的作用。症状一般在24-48h内自发消退，很少在几天内。对症治疗,包括甘露醇和类固醇可以考虑。在文学中,CIE仅在少数接受慢性HD治疗的ESRD患者中报告，我们是首例出现这种罕见并发症的慢性PD患者。
