Imai T, Izai M, Narimiya S, Nagaki M, Adachi T, Oohira T, Kamikubo K, Shiooka M, Fujioka H, Kotoo Y
Gifu Prefectural Gero Hot Spring Hospital and Medical Institute.
Nihon Naibunpi Gakkai Zasshi. 1988 Jul 20;64(7):582-92. doi: 10.1507/endocrine1927.64.7_582.
A case of pseudo-Bartter's syndrome associated with hypokalemic myopathy was presented. A 37-year-old housewife was admitted to our hospital because of muscle cramps with muscle weakness and tetany. There was a history of facial edema and constipation, which have been managed with "Kanpo medicine (Chinese medicine)" and laxatives for several years. The patient was amenorrhea 3 months before entry. She began to experience muscle weakness and muscle cramps associated with gait disturbance 2 or 3 months before admission. On physical examination, she was thin with positive Trousseau's and Chvostek's signs. Laboratory studies revealed hypokalemia, low urinary excretion of potassium, hypocalcemia, metabolic alkalosis, elevated creatine phosphokinase (CPK), increased levels of plasma renin activity and plasma aldosterone concentration, and decreased sensitivity to pressor effect of angiotensin II. Potassium supplementation resulted in restoration of her symptoms and normalization of low serum calcium and elevated CPK levels. She was diagnosed to be pseudo-Bartter's syndrome due to anorexia nervosa. The mechanism(s) of hypokalemia in our case was discussed.
本文报告了一例与低钾性肌病相关的假性巴特综合征病例。一名37岁的家庭主妇因肌肉痉挛伴肌无力和手足搐搦入住我院。患者有面部水肿和便秘病史，多年来一直服用“汉方药物（中药）”和泻药治疗。入院前3个月停经。入院前2至3个月开始出现肌无力和肌肉痉挛，并伴有步态障碍。体格检查发现患者消瘦，有特鲁索征和陶瑟征阳性。实验室检查显示低钾血症、尿钾排泄减少、低钙血症、代谢性碱中毒、肌酸磷酸激酶（CPK）升高、血浆肾素活性和血浆醛固酮浓度升高，以及对血管紧张素II升压作用的敏感性降低。补充钾后症状缓解，低血钙和升高的CPK水平恢复正常。患者被诊断为神经性厌食所致的假性巴特综合征。文中讨论了本例低钾血症的机制。
