Case of Pseudo-Bartter's Syndrome: An atypical presentation of cystic fibrosis

A three months infant who in the beginning had disease cystic fibrosis was diagonosed with pseudo-bartter's syndrome. The disease began with coughing, diarrhoea, vomiting and weakness. Investigation revealed; electrolytes showin hyponatremia (110 mmol/L) and hypokalemic (2.6 mmol/L) and hypochloremic (63 mmol/L) metabolic alkalosis (HCO3=43 mmol/L). Key words: Pseudo Bartter's Syndrome; Cystic fibrosis; Metabolic alkalosis. DOI: 10.3126/jnps.v31i2.3911 J Nep Paedtr Soc 2010;31(2):121-123

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Atypical presentation of cystic fibrosis: Obese adolescent with hypertension and pseudo-Bartter’s syndrome

Vojnosanitetski pregled ◽

10.2298/vsp1204367s ◽

2012 ◽

Vol 69 (4) ◽

pp. 367-369 ◽

Cited By ~ 5

Author(s):

Aleksandar Sovtic ◽

Predrag Minic ◽

Radovan Bogdanovic ◽

Natasa Stajic ◽

Milan Rodic ◽

...

Keyword(s):

Cystic Fibrosis ◽

Metabolic Alkalosis ◽

Caloric Intake ◽

Chloride Concentration ◽

Plasma Renin ◽

Holter Monitoring ◽

Atypical Presentation ◽

Bartter’S Syndrome ◽

Bartter's Syndrome ◽

Obese Adolescent

Introduction. Infants with cystic fibrosis may fail to thrive despite recommended caloric intake because of electrolyte disurbances caused by salt depletion resulting in hypochloremic metabolic alkalosis or pseudo-Bartter's syndrome. In most patients reported symptoms began in infancy, but it may be an initial presentation of disease in a previously healthy adolescent. Case report. A 15-year-old boy was admitted for evaluation of recurrent episodes of malaise associated with dehydration and acute renal insufficiency. Laboratory analysis showed hypochloremic metabolic alkalosis with hyponatremia and hypokalemia. On admission the boy was obese, with body weight of 95.5 kg (> P97), height 174 cm (> P75), and body mass index of 31.2 kg/m2 (> P95). Physical examination was inconclusive. Blood pressure holter monitoring proved significant systolic hypertension. Routine urinalysis, protein and electrolyte levels in urine were normal. Plasma renin and aldosteron were normal. Sweat chloride concentration was 63 mmol/L. Genetic testing confirmed the diagnosis of cystic fibrosis. Conclusion. To our knowledge, this is the first reported case of atypical presentation of cystic fibrosis in an adolescent presented with pseudo-Bartter's syndrome and signs of obesity and hypertension. We suggest that every patient with hypochloremic metabolic alkalosis should be evaluated for cystic fibrosis.

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On the complexity of the diagnosis of pseudo-Bartter's syndrome (a clinical case in a child with cystic fibrosis)

SOVREMENNAYA PEDIATRIYA ◽

10.15574/sp.2018.93.45 ◽

2018 ◽

pp. 45-48

Author(s):

S.I. Ilchenko ◽

◽

A.O. Fialkovska ◽

S.G. Ivanus ◽

◽

...

Keyword(s):

Cystic Fibrosis ◽

Clinical Case ◽

Bartter’S Syndrome ◽

Bartter's Syndrome

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Neo-Mull-Soy Metabolic Alkalosis: A Model of Bartter's Syndrome?

PEDIATRICS ◽

10.1542/peds.66.5.784 ◽

1980 ◽

Vol 66 (5) ◽

pp. 784-786

Author(s):

Vivian M. Reznik ◽

William R. Griswold ◽

Stanley A. Mendoza ◽

Richard M. McNeal

Keyword(s):

Metabolic Alkalosis ◽

Chloride Transport ◽

Chloride Concentration ◽

Thick Ascending Limb ◽

Loop Of Henle ◽

Bartter’S Syndrome ◽

Bartter's Syndrome ◽

Hypokalemic Alkalosis

A case of Neo-Mull-Soy-induced metabolic alkalosis occurred in an 8-month-old child. This child had hypochloremic hypokalemic alkalosis as well as hyperreninemia. Initially, a diagnosis of Bartter's syndrome was made and treatment consisted of KCl replacement, indomethacin, and aspirin. In retrospect, the diagnosis of Neo-Mull-Soy induced metabolic alkalosis could have been suspected on the basis of the low chloride concentration in his urine. Proposed mechanisms for the etiology of Bartter's syndrome are reviewed. Neo-Mull-Soy induced metabolic alkalosis simulates Bartter's syndrome and supports the concept that the primary abnormality in Bartter's syndrome is chloride deficiency. The chloride deficiency in Bartter's syndrome results from a defect in active chloride transport in the thick ascending limb of the loop of Henle.

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