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- Kota Kakeshita, Teruhiko Imamura, Tsutomu Koike, Hayato Fujioka, Taigo Kiyosawa, Ayako Shimizu, Hidenori Yamazaki, and Koichiro Kinugawa.
- The Second Department of Internal Medicine, University of Toyama, Japan.
- Intern. Med. 2023 Apr 1; 62 (7): 103110351031-1035.
AbstractA 47-year-old man was complaining of consciousness disorder. He had acute kidney injury, hypokalemia, and severe metabolic alkalosis. Initial treatment using intravenous infusion of 0.9% saline and potassium chloride improved his consciousness. It was clarified that he was a severe alcohol abuser who habitually self-vomited. We diagnosed him with volume depletion and pseudo-Bartter's syndrome due to loss of chloride by habitual vomiting. Gastrointestinal endoscopy demonstrated pyloric stenosis, which was ameliorated by Helicobacter pylori eradication therapy. We should consider volume depletion and pseudo-Bartter's syndrome as differential diagnoses when we encounter patients with acute kidney injury and severe metabolic alkalosis.
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