頁籤選單縮合
題名 | A Puzzling Cause of Worsening Hypertension and Hypokalemia= |
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作者 | Shiang,Jeng-chuan; Kuo,Tai-song; Lin,Shih-hua; |
期刊 | 臺灣腎臟醫學會雜誌 |
出版日期 | 20010900 |
卷期 | 15:3 2001.09[民90.09] |
頁次 | 頁95-96 |
分類號 | 415.74 |
語文 | eng |
關鍵詞 | |
英文摘要 | A 51-year-old male presented to the neurological deprtment with progressive muscular wekness. He had a 3-year history of hypertension well controlled with angiotensin converting enzyme inhibitor (captopril), β-blocker (atenolol) and calcium blocker (amlodipine). One month earlier, he was admitted due to transitent ischemic attack (TIA). At that time, his plasma potassium concentration was 4.1 mmol/L. After recovery, he started to consume Chinese herb powder 12 gm daily to prevent TIA for 3 weeks. He denied nausea, vomiting, diarrhea or the use of diuretics. His family history was noncontributory. Consciousness was alert. Body weight gained 2 kg to 63 kg. Blood pressure was 200/110 mmHg, heart rate 80 bedts/min, respiratory rate 16/min, and body temperature 36.5℃. Carotid bruit was not audible. Thyroid gland was not enlarged. Cardiopulmonary examination was unremarkable. There was a symmetrically decreased muscle power of the lower extremities. The remainder of the physical examination was normal. EKG revealed normal sinus rhythm with prominent U waves. Blood routine was normal. Biochemical studies were as follows: Na+ 143 mmol/L, K+ 2.5 mmol/L, Cl- 99 mmol/L, total CO, 30 mmol/L, urea 15 mg/dl, creatinine 0.9 mg/dL, glucose 104 mg/dL, and osmolality 293 mosm/kgH2O. urine K+ concentration was 16 mmol/L and osmolality 350 mosm/kgH2O. An early morning cortisol level was 506 nmol/L (normal range 140-690), supine plasma rennin activity 0.06 ng/L per s (normal 0.11-0.69) and supine aldosterone concentrations 2 pmol/L (normal 111-860). Thyroid and liver function tests were normal. CXR and KUB were essentially normal. There were no renal or adrenal abnormalities on bdominal sonography and computed tomography. |
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