Bökenkamp A, Eckard R, Jorch G, Michel E, Kuwertz E
Klinik und Poliklinik für Kinderheilkunde Westfälischen Wilhelms-Universität Münsten.
Klin Padiatr. 1988 Jul-Aug;200(4):344-9. doi: 10.1055/s-2008-1033733.
The clinical course of a mannitol intoxication in a 5-month-old infant is reported. Mannitol measurements were performed by gas-chromatographic-mass-spectrometric analysis. The role of the osmolal gap as a simple diagnostic tool in mannitol intoxication was underlined by comparison to serum mannitol levels. Mannitol elimination was analysed by measuring mannitol levels in urine, ultrafiltrate, and peritoneal dialysis outflow. The highest concentrations were found in urine (approx. 300% serum values) and the lowest in peritoneal dialysis outflow (approx. 50% serum levels). "Total body Mannitol" was calculated each day from body weight, hydration, and serum mannitol levels and opposed to the amount eliminated via urine, ultrafiltration, and peritoneal dialysis. The results were only compatible with a volume of distribution of approx. 5.3 1, representing total body water at a lean body weight of 7 kg. It could thus be demonstrated that the sudden fall of serum mannitol levels from 19.6 mg/ml to 5.5 mg/ml without dialysis treatment in an anuric patient was due to a leak of mannitol into the intracellular compartment.
报告了一名5个月大婴儿甘露醇中毒的临床病程。通过气相色谱-质谱分析进行甘露醇测量。通过与血清甘露醇水平比较，强调了渗透压间隙作为甘露醇中毒简单诊断工具的作用。通过测量尿液、超滤液和腹膜透析流出液中的甘露醇水平来分析甘露醇的消除情况。尿液中浓度最高（约为血清值的300%），腹膜透析流出液中浓度最低（约为血清水平的50%）。每天根据体重、水合状态和血清甘露醇水平计算“全身甘露醇”，并与通过尿液、超滤和腹膜透析消除的量进行对比。结果仅与约5.3升的分布容积相符，这代表了体重7公斤的瘦体重时的全身水量。因此可以证明，在一名无尿患者中，未经透析治疗血清甘露醇水平从19.6毫克/毫升突然降至5.5毫克/毫升是由于甘露醇漏入细胞内间隙所致。
