Ramos E, Hall-Craggs M, Demers L M
JAMA. 1980 Mar 14;243(10):1070-2.
A patient with hypokalemic alkalosis, normotensive hyperreninism, hyperaldosteronism, increased levels of urinary and plasma prostaglandin E, and vascular hyporesponsivity to angiotensin II was thought to have Bartter's syndrome. Results of a kidney biopsy showed hyperplasia of the juxtaglomerular apparatus but no renomedullary cell hyperplasia. A 24-hour urine collection showed a low chloride level and no increase in the fractional chloride clearance, thus excluding Bartter's syndrome. Subsequent disclosure of surreptitious, habitual vomiting explained the hypokalemia.
一名患有低钾性碱中毒、血压正常的高肾素血症、醛固酮增多症、尿和血浆前列腺素E水平升高以及血管对血管紧张素II反应性降低的患者被认为患有巴特综合征。肾脏活检结果显示肾小球旁器增生，但肾髓质细胞无增生。24小时尿液收集显示氯化物水平低，氯化物清除分数无增加，从而排除了巴特综合征。随后发现患者有隐匿性习惯性呕吐，这就解释了低钾血症的原因。
