14 September 2012
Type IV neonatal Bartter syndrome complicated with congenital chloride diarrhea
Hale Sakallı, Hakan BucakDOI: 10.12659/AJCR.883446
Am J Case Rep 2012; 13:230-233
Abstract
Background: Pseudo-Bartter syndrome encompasses a heterogenous group of disorders similar to Bartter syndrome. Sometimes a few status may be nested, as in our case presented here.
Case Report: An 8-month-old boy was referred to our hospital with of intractable diarrhea, polyuria, persistent hypokalemia, abdominal distension and failure to thrive. He was born in the 34 6/7 gestational week (GW) to consanguineous parents. In the 30th GW polyhydramnios was verified by ultrasonography. The laboratory results showed hypokalemic-hypochloremic metabolic alkalosis, hyponatremia, and increased urinary loss of chloride, potassium and calcium. An audiogram test revealed complete sensorineural deafness. Ultrasonography revealed medullary nephrocalcinosis in both kidneys. Elevated plasma renin activity and aldosterone were found and a provisional diagnosis of type-IV neonatal Bartter syndrome was made. Treatment with indomethacin, spironolactone and additional intake of NaCl/KCl was initiated. Despite these therapies, the child’s diarrhea persisted but serum potassium concentration normalized, and hypercalciuria and urine output reduced. After determining the high fecal chloride concentration, there was an immediate decompensation of the disease on indomethacin withdrawal, thus a diagnosis of type IV neonatal Bartter syndrome complicated with congenital chloride diarrhea was considered. Indomethacin, spironolactone and supplementary therapies with NaCl/KCl were continued, which resulted in the normalization of serum electrolytes as well as his physical development, but high contents of chloride in urine and faeces and nephrocalcinosis remains unchanged during 1-year follow-up.
Conclusions: Because of the clinical and laboratory simulations between the various diseases that lead to hypokalemic-hypochloremic metabolic alkalosis, patients must be evaluated carefully.
Keywords: Diarrhea - congenital, Alkalosis, hypokalemic-hypochloremic metabolic alkalosis, Bartter Syndrome, Hypokalemia
In Press
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.946588
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.946011
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945910
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945852
Most Viewed Current Articles
21 Jun 2024 : Case report
88,930
DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report
50,135
DOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
20 Nov 2023 : Case report
25,494
DOI :10.12659/AJCR.941424
Am J Case Rep 2023; 24:e941424
18 Feb 2024 : Case report
22,670
DOI :10.12659/AJCR.943030
Am J Case Rep 2024; 25:e943030