The clinical presentation, treatment, and follow-up of two boys with type 1 Dent disease who exhibited a Bartter-like phenotype were retropectively analysed. The related literature of pediatric patients with type 1 Dent disease who had hypokalemia and metabolic alkalosis was screened through databases such as PubMed, CNKI, and Wanfang until February 1, 2024, and common features among these patients were summarized through literature review. A total of 7 literatures were included, and 9 children were included in the analysis. All patients were male, presenting with significant low molecular weight proteinuria and hypercalciuria. Other prominent characteristic phenotypes included short stature (7/8), hypophosphatemia (8/9), and rickets (6/8). Seven previously reported patients had missense or nonsense mutations, while 2 patients in this study carried possible pathogenic mutations in the CLCN5 gene, c.315+2T>A (p.?) and c.584dupT (p.I196Yfs*6), respectively. Five patients were able to maintain blood potassium levels around 3 mmol/L with oral potassium chloride solution combined with non-steroidal anti-inflammatory drugs (ibuprofen or indomethacin). The follow-up showed that 2 patients developed chronic kidney disease stage 4 and stage 3 at the age of 13 and 21 years, respectively. The phenotypic overlap between Dent disease and Batter syndrome is considerable,with the distinguishing feature being the presence of significant low molecular weight proteinuria. Patients with type 1 Dent disease presenting with the Bartter-like phenotype have a high prevalence of short stature, hypophosphatemia, and rickets. Non-steroidal anti-inflammatory drugs can be used to correct hypokalemia in patients under periodic renal function assessment.
回顾性分析2例以巴特样表型起病的登特病1型男性患儿的临床表现、治疗及随访。检索PubMed、知网、万方等数据库,从建库至2024年2月1日,筛选低钾血症合并代谢性碱中毒的登特病1型患儿相关文献,通过文献复习总结此病患儿的临床特征。纳入7篇文献,9例患儿纳入分析。患者均为男性,均有大量低分子蛋白尿和高钙尿症,其他突出的特征性表型包括身材矮小(7/8)、低磷血症(8/9)及佝偻病(6/8)。已报道的7例患者为CLCN5基因错义或无义突变,本研究报道的2例患者分别携带CLCN5基因可能致病性突变:c.315+2T>A(p.?)及c.584dupT(p.I196Yfs*6)。5例患者经氯化钾口服液联合非甾体类抗炎药(布洛芬或吲哚美辛)能维持血钾水平在3 mmol/L左右。随访显示有2例患者分别在13和21岁时出现慢性肾脏病4期和3期。登特病与巴特综合征表型重合度高,鉴别点在于是否存在大量低分子蛋白尿。以巴特样表型起病的登特病1型患者身材矮小、低磷血症及佝偻病的发生率高。在定期检测肾功能的情况下,非甾体抗炎药可用于纠正患者的低钾血症。.