以顽固性低血钾就诊神经内科的远端肾小管性酸中毒1例报告

Case Report of A Patient with Distal Renal Tubular Acidosis Admitted Into Neurology Department With Refractory Hypopotassemia

探讨继发于远端肾小管性酸中毒的低钾型周期性瘫痪的临床特点、诊断及治疗方法。经口服枸橼酸合剂、碳酸氢钠等纠正酸中毒治疗后,患者血钾恢复正常。1年内随访未见肢体无力发作,复查血钾亦正常。对于反复出现低钾瘫痪的患者,需详细询问病史,特别注意是否合并甲状腺功能亢进、肾小管性酸中毒、干燥综合征等代谢障碍或内分泌系统疾病的症状和体征,避免误诊和漏诊。

To investigate the clinical characteristics, diagnosis and treatment of hypokalemic periodic paralysis secondary to distal renal tubular acidosis. Serum potassium came to be normal after being served with citric acid and sodium bicarbonate taken orally. Dur- ing the one - year follow - up, no limb asthenia was observed, and the serum potassium stayed normal in the re - examination. For the patients with recurrent hypokalemic paralysis, concern should be raised over their medical history, especially over the symptoms of dysbolism or endocrine system diseases, such as hyperthyroidism, distal renal tubular acidosis, sicca syndrome, in order to avoid misdiagnosis and missed diagnosis.