Bień B, Lamnari A M, Górska M
Wojewódzki Szpital Zespolony im. J. Sniadeckiego w Białymstoku.
Pol Arch Med Wewn. 1995 Nov;94(5):442-6.
A case is presented of a 30-year old man with long-term history of painful muscle cramps, episodes of tetany, general malaise and persistent hypokaliemia. On the ground of clinical appearance and biochemical data the Bartter's syndrome in Gitelman's variant was diagnosed. In differential diagnosis we considered renal tubular acidosis, other tubular defects (Liddle's syndrome), primary and secondary hyperaldosteronism. Other possible causes of hypokaliemia were excluded such as surreptitious diuretic and lexative abuse, persistent vomiting and diarrhea. Good therapeutic effect were achieve using spironolacton, indomethacin, propranolol and potassium supplementation.
本文报告一例30岁男性患者，有长期肌肉疼痛性痉挛、手足搐搦发作、全身不适及持续性低钾血症病史。根据临床表现和生化数据，诊断为吉特曼变异型巴特综合征。在鉴别诊断中，我们考虑了肾小管酸中毒、其他肾小管缺陷（利德尔综合征）、原发性和继发性醛固酮增多症。排除了低钾血症的其他可能原因，如隐匿性利尿剂和泻药滥用、持续性呕吐和腹泻。使用螺内酯、吲哚美辛、普萘洛尔和补充钾取得了良好的治疗效果。
