Tabish Mohammad, Mahendran Manjit, Ray Animesh, Vikram Naval Kishore
Medicine, All India Institute of Medical Sciences, New Delhi, India.
Medicine, All India Institute of Medical Sciences, New Delhi, India
BMJ Case Rep. 2020 Feb 5;13(2):e232630. doi: 10.1136/bcr-2019-232630.
Colistin-induced nephrotoxicity is commonly associated with elevation of serum creatinine level or a reduction of urine output. Uncommonly, tubulopathy associated with colistin has been reported. Here we present a unique case of a 46-year-old man who developed polyuria, hypokalaemia, hypocalcaemia, hypomagnesemia and metabolic alkalosis after 3 days of therapy with intravenous colistimethate sodium. After ruling out other causes, a diagnosis of colistin-induced acquired Bartter syndrome was made. The patient required daily aggressive intravenous repletion of fluids and electrolytes. However, polyuria and metabolic abnormalities abated only after drug discontinuation.
黏菌素引起的肾毒性通常与血清肌酐水平升高或尿量减少有关。罕见的是，有报告称黏菌素会引发肾小管病。在此，我们呈现一例独特病例，一名46岁男性在静脉注射多黏菌素甲磺酸钠治疗3天后出现多尿、低钾血症、低钙血症、低镁血症和代谢性碱中毒。在排除其他病因后，诊断为黏菌素诱发的获得性巴特综合征。该患者需要每日积极静脉补充液体和电解质。然而，多尿和代谢异常仅在停药后才减轻。
