Clinical Characteristics of Brucellosis Complicated by Syndrome of Inappropriate Secretion of Antidiuresis / 中国医学科学院学报

To summarize and analyze the causes of hyponatremia in patients with brucellosis and explore the clinical manifestations of syndrome of inappropriate antidiuresis(SIAD)in patients with brucellosis. The clinical data of 111 patients with acute brucellosis who were treated in Peking Union Medical College Hospital from September 2011 to December 2017 were retrospectively reviewed.Hyponatremia was defined by serum sodium level lower than 135 mmol/L.Clinical characteristics including medical histories,vital signs,and laboratory test findings were collected and analyzed. Hyponatremia was found in 14(12.6%)of 111 patients with brucellosis,among whom 3 patients were confirmed to be with SIAD,10 were suspected as SIAD,and 1 was diagnosis as hypopituitarism.Hypoalbuminemia,elevation of erythrocyte sedimentation rate,and high sensitivity C reactive protein were found in brucellosis patients with SIAD,along with severe complications such as infective endocarditis,septic shock,and anemia. Hyponatremia is not a rare condition in brucellosis patients and may be caused by SIAD.

Clinical character and genetic mutation of 64 patients with Gitelman syndrome / 基础医学与临床

Objective To study the clinical and genetic profile of the patients with Gitelman syndrome ( GS ) . Methods We retrospectively analyzed the gene mutation and clinical character of 64 GS patients diagnosed in Pe-king Union Medical College Hospital from 2012 to 2016 .Results The age at diagnosis of these 64 patients ( 39 male,25 female) were (35±14) years.At admission, the serum potassium level of the patients was (2.86± 0.44) mmol/L, serum magnesium level was ( 0.62 ±0.14 ) mmol/L, 24-hour urine potassium was ( 82.27 ± 39.73)mmol/day, 24-hour urine calcium was (0.94±0.83)mmol/day and their average blood pressure was 110/69 mmHg.The gene mutation were divided into four groups including homozygous mutation ( n=5) , compound het-erozygous mutation(n=40), multiple mutations (n=9) and single heterozygous mutation (n=10) group.The compound heterozygous group had higher serum potassium concentration ( P<0.05 ) and the homozygous group had a relatively higher serum magnesium concentration but without significance .A total of 74 distinctly different mutation alleles were identified , of which 24 were new mutation alleles .p.Asp486Asn was a hotspot in our series which was found in 16 patients ( 25.0%) .Conclusions There exists great heterogeneity of gene mutation and clini-cal character in Gitelman syndrome .Patients with compound heterozygous have a relatively milder clinical character.p.Asp486Asn mutation is a hotspot in Chinese patients .