Bartter's syndrome with type 2 diabetes mellitus.
J Chin Med Assoc
; 72(2): 88-90, 2009 Feb.
Article
em En
| MEDLINE
| ID: mdl-19251537
ABSTRACT
We report a rare case of Bartter's syndrome in a 35-year-old woman with type 2 diabetes mellitus. The patient presented with leg weakness, fatigue, polyuria and polydipsia. Hypokalemia, metabolic alkalosis, and high renin and aldosterone concentrations were present, but the patient was normotensive. Gitelman's syndrome was excluded because of the presence of hypercalciuria, secondary hyperparathyroidism and bilateral nephrocalcinosis. The patients condition improved upon administration of a prostaglandin synthetase inhibitor (acemetacin), oral potassium chloride and potassium-sparing diuretics. Five months later, the patient discontinued acemetacin because of epigastric discomfort; at the same time, severe hypokalemia and hyperglycemia developed. Glucagon stimulation and water deprivation tests were performed. Type 2 diabetes mellitus with nephrogenic diabetes insipidus was diagnosed. To avoid further gastrointestinal complications, the patient was treated with celecoxib, a selective cyclooxygenase 2 inhibitor. This case serves as a reminder that Bartter's syndrome is associated with various metabolic derangements including nephrogenic diabetes insipidus, nephrocalcinosis and diabetes mellitus. When treating Bartter's syndrome, it is also prudent to remember that the long-term use of nonsteroidal anti-inflammatory drugs and potassium-sparing diuretics may result in serious adverse reactions.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Bartter
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Diabetes Mellitus Tipo 2
Limite:
Adult
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Female
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Humans
Idioma:
En
Revista:
J Chin Med Assoc
Assunto da revista:
MEDICINA
Ano de publicação:
2009
Tipo de documento:
Article