Henoch-Schönlein Purpura 신염 환자에서 경정맥 고용량 스테로이드 충격요법 후 발생된 저칼륨혈증으로 인한 다뇨증과 야간뇨 |
김근정, 이준호 |
1차의과대학교 분당차병원 소아청소년과 2차의과대학교 분당차병원 소아청소년과 |
Hypokalemia-induced Polyuria with Nocturia after Intravenous Methylprednisolone Pulse Therapy in a Henoch-Schonlein Purpura Nephritis Patient |
Geun-Jung Kim, Jun-Ho Lee |
1Department of Pediatrics, CHA University, CHA Bundang Medical Center 2Department of Pediatrics, CHA University, CHA Bundang Medical Center |
Received: August 6, 2010; Revised: August 26, 2010. Accepted: September 3, 2010. |
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ABSTRACT |
Patients with moderate to severe degrees of Henoch-Schonlein purpura (HSP) nephritis receive high-dose intravenous methylprednisolone pulse therapy (IMPT). Although the regimen is generally safe and effective, various complications occasionally develop. administration of excessive corticosteroid can induce urinary potassium wasting leading to hypokalemia. Polyuria, one of the complications of hypokalemia, is related to both increased thirst and mild nephrogenic diabetes insipidus. And hypokalemia itself also impairs the maximal renal urinary concentration ability. Although polyuria or nocturia after IMPT is not common, it is correctable immediately by oral potassium supplementation. Therefore, during IMPT, careful history taking of nocturia as well as monitoring urine volume, serum and urine potassium level at regular follow-up are necessary because even mild hypokalemia can provoke urine concentrating ability defect. We experienced a case of 11 year-old boy with HSP nephritis who suffered from hypokalemia-induced polyuria with nocturia right after IMPT. |
Key words:
Methylprednisolone pulse therapy | Hypokalemia | Polyuria | Nocturia | Henoch-Schonlein Purpura nephritis |
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