Onem Yalcin, Kucukardali Yasar, Sahan Burak, Atasoyu Enes Murat, Ipcioğlu Osman, Terekeci Hakan, Solmazgul Emrullah, Top Cihan, Oktenli Cagatay
GATA Haydarpasa Teaching Hospital, Department of Internal Medicine, Istanbul, Turkey.
Ren Fail. 2008;30(7):691-4. doi: 10.1080/08860220802212718.
The two most common forms of inherited normotensive hypokalemic metabolic alkalosis are Bartter's and Gitelman's syndromes. Bartter's is mostly seen in children, while Gittelman's is mostly seen in adolescents and adults. We analyze three subjects of adult-onset Gitelman's and Bartter's syndrome. The patients applied to our hospital due to severe hypokalemia with little clinical expression (paresthesia, cramp, polyuria, polydipsia, and/or weakness). All had normal blood pressure, hypokalemia, hyperreninemic hyperaldosteronism, and a decrease in the fractional chloride reabsorption. Key elements in differential diagnosis of chronic hypokalemia are blood pressure assessment, acid base equilibrium, serum calcium concentration, and 24-hour urine potassium and calcium excretion.
遗传性正常血压性低钾血症代谢性碱中毒的两种最常见形式是巴特综合征和吉特曼综合征。巴特综合征多见于儿童,而吉特曼综合征多见于青少年和成年人。我们分析了3例成人起病的吉特曼综合征和巴特综合征患者。这些患者因严重低钾血症且临床表现轻微(感觉异常、痉挛、多尿、烦渴和/或乏力)前来我院就诊。所有患者血压正常、低钾血症、肾素增多性醛固酮增多症以及氯分数重吸收降低。慢性低钾血症鉴别诊断的关键因素是血压评估、酸碱平衡、血清钙浓度以及24小时尿钾和钙排泄量。