PDF(Pubmed)
Abstract：
Bartter syndrome is a genetic disorder characterised by chloride-unresponsive metabolic alkalosis, hypokalaemia, hypomagnesaemia and hypercalciuria. While it commonly presents antenatally or in early infancy, sometimes, drugs can induce a state similar to Bartter syndrome in any age group, called acquired Bartter syndrome. Polymyxins and aminoglycosides are the most commonly implicated drugs. Polymyxin B and polymyxin E (popularly known as colistin) are the two chemically similar polymyxins that are commonly used clinically. While colistin is frequently associated with nephrotoxicity, polymyxin B is generally considered less nephrotoxic. This difference is due to the way these two drugs are handled by the kidneys. In this case report, we discuss a middle-aged male who developed Bartter syndrome due to polymyxin B, which resolved on discontinuation of the drug, and re-appeared after its re-introduction later. This case exemplifies the nephrotoxicity caused by polymyxin B and the need for vigilance when using this drug.
摘要：
Bartter综合征是一种遗传性疾病，以氯化物无反应的代谢性碱中毒为特征，低钾血症,低镁血症和高钙尿症。虽然它通常在产前或婴儿期早期出现，有时,药物可以在任何年龄组诱发类似于巴特综合征的状态，称为获得性巴特综合征。多粘菌素和氨基糖苷是最常见的牵连药物。多粘菌素B和多粘菌素E（俗称粘菌素）是临床上常用的两种化学上相似的多粘菌素。虽然粘菌素经常与肾毒性有关，多粘菌素B通常被认为肾毒性较小。这种差异是由于这两种药物由肾脏处理的方式。在这个案例报告中,我们讨论了一个因多粘菌素B而发展为Bartter综合征的中年男性,在停药后解决了，并在后来重新引入后重新出现。此病例说明了多粘菌素B引起的肾毒性以及使用该药物时需要警惕。
