Journal of Yeungnam Medical Science

Case Reports

Rheumatoid arthritis accompanied by Gitelman syndrome: Min Gi Park, Ji Hyun Lee, Sung Jun Kim, Su Ho Park, Suk Ki Park, Joon Sul Choi, Ji Yeon Hwang; Yeungnam Univ J Med. 2017;34(1):101-105. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.101

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Abstract PDF: Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.

Furosemide induced medullary nephrocalcinosis mimicking Bartter syndrome.: Sohee Kim, Chanhee Kyung, Yong Hoon Kim, Jang Ho Cho, Changhyeok Hwang, Jung Eun Lee; Yeungnam Univ J Med. 2014;31(1):21-24. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.21

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Abstract PDF: Clinical presentation of Bartter syndrome is similar to surrepitious vomiting or use of diuretics. Therefore, precise differential diagnosis of Bartter syndrome is crucial. We report a case of medullary nephrocalcinosis (MNC) induced by furosemide mimicking Bartter syndrome. A 55-year-old female patient visited our hospital with renal dysfunction on basis of hypokalemia and metabolic alkalosis. She had no history of hypertension or drug use except allopurinol and atorvastatin. She did not complain of nausea or vomiting on presentation and the serum magnesium level was normal. We performed ultrasonography, that showed MNC. For these reasons, we suspected Bartter syndrome and corrected the electrolyte imbalance. During outpatient follow up, we found that the patient had been taking 400 mg of furosemide daily for 30 years. We could diagnose furosemide induced MNC, and recommended to her to reduce the amount of furosemide.

Original Article

Effects of furosemide on perioperative serum osmolality and electrolytes during transurethral resection of the prostate: Sae Yune Kim, Un Seok Roh, Dae Pal Park; Yeungnam Univ J Med. 1992;9(1):110-120. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.110

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Abstract PDF: The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate. 30 patients, who belonged to physical status II or III of ASA classification, were selected randomly and divided with two groups as follows: G1 (N=15): Not-administrated furosemide (control group) G2 (N=15): Administrated furosemide (Experimental group) All patients were premedicated with Hydroxyzine (1mg/kg, IM) and were performed continuous epidural anesthesia with 2% lidocaine (1-1.5mg/segment). For irrigating solution, 5% D-sorbitol was used and Hartman's solution were given for maintenance fluid and fixed the height of irrigating container to 60 cm from symphysis pubis. With the starting of operation, 20 mg furosemide was administrated to experimental group. The blood samples for the values of Na⁺, K⁺, Glucose and BUN were performed at the periods of preoperation, 10 min, 20 min, 30 min after the starting of operation and immediate postoperation. Based these date, serum osmolality and effective osmolality were calculated. The results were as follows: 1. The sodium concentration of control group was decreased statistically significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value (p<0.05). But that of experimental Group was not changed significantly. 2. The serum osmolality and effective osmolality were decreased statistically significantly at 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value (p<0.05). But those of experimental group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraoperatively. And so we recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.

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