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題 名 | Bartter's Syndrome with Type 2 Diabetes Mellitus=Bartter氏症併有第二型糖尿病 |
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作 者 | 施婷婷; 李少白; | 書刊名 | 中華醫學會雜誌 |
卷 期 | 72:2 2009.02[民98.02] |
頁 次 | 頁88-90+a17 |
分類號 | 415.593 |
關鍵詞 | 糖尿病; 低血鉀; 症候群; Bartter; Diabetes mellitus; Hypokalemia; Syndrome; |
語 文 | 英文(English) |
英文摘要 | We report a rare case of Bartter’s syndrome in a 35-year-old woman with type 2 diabetes mellitus. The patient presented with leg weakness, fatigue, polyuria and polydipsia. Hypokalemia, metabolic alkalosis, and high renin and aldosterone concentrations were present, but the patient was normotensive. Gitelman’s syndrome was excluded because of the presence of hypercalciuria, secondary hyperparathyroidism and bilateral nephrocalcinosis. The patient’s condition improved upon administration of a prostaglandin synthetase inhibitor (acemetacin), oral potassium chloride and potassium-sparing diuretics. Five months later, the patient discontinued acemetacin because of epigastric discomfort; at the same time, severe hypokalemia and hyperglycemia developed. Glucagon stimulation and water deprivation tests were performed. Type 2 diabetes mellitus with nephrogenic diabetes insipidus was diagnosed. To avoid further gastrointestinal complications, the patient was treated with celecoxib, a selective cyclooxygenase 2 inhibitor. This case serves as a reminder that Bartter’s syndrome is associated with various metabolic derangements including nephrogenic diabetes insipidus, nephrocalcinosis and diabetes mellitus. When treating Bartter’s syndrome, it is also prudent to remember that the long-term use of nonsteroidal anti-inflammatory drugs and potassium-sparing diuretics may result in serious adverse reactions. |
本系統中英文摘要資訊取自各篇刊載內容。