Wechsler B, Colin J Y, Raux-Eurin M G, Conessa J M, Godeau P
Ann Med Interne (Paris). 1981;132(4):241-5.
The authors report a case of severe hyperkalemia (7 mmol/l) in an insulin-dependent diabetic in the absence of renal failure. This hyperkalemia was due to hypoaldosteronism caused by inadequate hormone biosynthesis in the absence of 21-hydroxylase. Replacement therapy allowed normalization of clinical and laboratory parameters. The various causes of hyperkalemia in the absence of renal failure in insulin-dependent diabetes are discussed, notably the renin deficiency hypoaldosteronism syndrome. This case study is remarkable for a number of reasons, including the very limited degree of virilization, the occurrence of a pregnancy, and the degree of salt excretion. This is a new observation in the diabetic, and is apparently a coincidental association since deficits in 21-hydroxylase are not usually associated with insulin-dependent diabetes.
作者报告了一例胰岛素依赖型糖尿病患者在无肾衰竭情况下发生严重高钾血症（7 mmol/l）的病例。这种高钾血症是由于在缺乏21-羟化酶的情况下激素生物合成不足导致的醛固酮缺乏症。替代疗法使临床和实验室参数恢复正常。讨论了胰岛素依赖型糖尿病患者在无肾衰竭时高钾血症的各种原因，特别是肾素缺乏性醛固酮缺乏症综合征。该病例研究在多个方面值得注意，包括男性化程度非常有限、怀孕的发生以及盐排泄程度。这是糖尿病患者中的一项新观察结果，显然是一种偶然关联，因为21-羟化酶缺乏通常与胰岛素依赖型糖尿病无关。
