Steiner R W, Omachi A S
Am J Kidney Dis. 1986 Mar;7(3):245-9. doi: 10.1016/s0272-6386(86)80012-9.
Marked renal potassium and magnesium wasting, alkalosis, and a progressive increase in plasma renin and eventual hyperaldosteronemia developed during a 15-month course of in-hospital capreomycin therapy that was necessary for drug-resistant pulmonary tuberculosis. A prominent feature of the present case was renal chloride wasting, a feature of the capreomycin syndrome that has previously received little attention. Similar potentially life-threatening metabolic abnormalities, which resemble those found in Bartter's syndrome, can occur during prolonged therapy with the antibiotic gentamicin. In the present case, electrolyte abnormalities were unaffected by three days of indomethacin therapy but were partially corrected by large doses of spironolactone. Capreomycin, viomycin (an antibiotic closely related to capreomycin), and gentamicin are highly basic polypeptide antibiotics that may induce strikingly similar and potentially fatal syndromes of renal tubular dysfunction that can feature multiple electrolyte abnormalities.
在因耐多药肺结核而进行的为期15个月的院内卷曲霉素治疗过程中，出现了明显的肾钾和镁流失、碱中毒，血浆肾素逐渐升高并最终出现高醛固酮血症。本病例的一个突出特征是肾氯流失，这是卷曲霉素综合征的一个特征，此前很少受到关注。在使用抗生素庆大霉素进行长期治疗期间，可能会出现类似巴特综合征中发现的、类似的潜在危及生命的代谢异常。在本病例中，吲哚美辛治疗三天对电解质异常没有影响，但大剂量螺内酯部分纠正了电解质异常。卷曲霉素、紫霉素（一种与卷曲霉素密切相关的抗生素）和庆大霉素是高度碱性的多肽抗生素，它们可能诱发肾小管功能障碍的极其相似且潜在致命的综合征，其特征可能是多种电解质异常。
