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吉特林综合征并发轻度肾功能不全和高阴离子间隙酸中毒;一名年轻女性的罕见病例。

Gitelman's syndrome complicated by mild renal insufficiency and high anion gap acidosis; a rare presentation in a young female.

作者信息

Hassan Jafry Nazrul, Ahmed Ejaz, Mubarak Muhammed

机构信息

Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

出版信息

J Nephropathol. 2015 Apr;4(2):38-42. doi: 10.12860/jnp.2015.08. Epub 2015 Apr 1.

Abstract

BACKGROUND

Gitelman's syndrome (GS) is a rare autosomal recessive renal tubular disorder that is characterized by episodic clinical manifestations and persistent biochemical abnormalities. The disorder manifests in adolescent or adult age and is characterized by transient episodes of muscle weakness and tetany. Its diagnosis requires a high index of suspicion and skillful interpretation of laboratory investigations.

CASE PRESENTATION

We herein present a case of a 20-year-old female patient who presented with generalized muscle weakness and mild renal insufficiency. Laboratory investigations revealed mild azotemia, high anion gap acidosis, hypokalemia, hypomagnesemia, and hypocalciuria. She recovered her renal functions and muscle power with appropriate management and is doing well seven months after her first presentation to our hospital.

CONCLUSIONS

This case highlights the need to create high index of suspicion among the general practitioners about this syndrome and an early referral of such patients to nephrologists for an accurate diagnosis and appropriate management.

摘要

背景

吉特曼综合征(GS)是一种罕见的常染色体隐性遗传性肾小管疾病,其特征为发作性临床表现和持续性生化异常。该疾病在青少年或成年期发病,表现为短暂的肌肉无力和手足搐搦发作。其诊断需要高度的怀疑指数和对实验室检查结果的专业解读。

病例报告

我们在此报告一例20岁女性患者,该患者出现全身肌肉无力和轻度肾功能不全。实验室检查显示轻度氮质血症、高阴离子间隙酸中毒、低钾血症、低镁血症和低钙尿症。经过适当治疗,她的肾功能和肌肉力量得以恢复,自首次到我院就诊七个月后情况良好。

结论

该病例强调了全科医生对此综合征保持高度怀疑指数的必要性,以及此类患者应尽早转诊至肾病科医生处以便进行准确诊断和适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/452f/4417668/da4ce3d8bde2/JNP-4-38-g001.jpg

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