Abstract
BackgroundBartter’s syndrome is a rare genetic tubulopathy affecting the loop of Henle leading to salt wasting. It is commonly seen in utero or in early neonatal period. Rare cases of acquired Bartter’s syndrome are reported in association with infections like tuberculosis, granulomatous conditions like sarcoidosis, autoimmune diseases, and drugs. The mainstay of management includes potassium, calcium, and magnesium supplementation.Case presentationWe report the case of a 62-year-old Sri Lankan Sinhalese man with diabetes and hypertension presenting with generalized weakness with clinical evidence of proximal myopathy. He was severely hypokalemic with high urinary potassium excretion and hypochloremic metabolic alkalosis. He poorly responded to intravenously administered potassium supplements. A diagnosis of idiopathic Bartter-like phenotype was made. He responded well to spironolactone and indomethacin.ConclusionsPatients presenting with body weakness need serum potassium estimation. Acquired Bartter’s syndrome although rare, should be ruled out in those with hypokalemia and metabolic alkalosis with increased urinary potassium loss with poor response to potassium replacement.
Highlights
Bartter’s syndrome is a rare genetic tubulopathy affecting the loop of Henle leading to salt wasting
Patients presenting with body weakness need serum potassium estimation
Very few cases of acquired Bartter’s syndrome (BS) are described in the literature; they are commonly associated with tuberculosis, autoimmune conditions, sarcoidosis, or following administration of drugs such as aminoglycosides [5,6,7,8,9,10,11,12]
Summary
Hypokalemia should be ruled out when patients present with generalized weakness of the body. Availability of data and materials Data sharing not applicable to this article as no datasets were generated or analyzed during the current study. All authors read and approved the final manuscript. Ethics approval and consent to participate Ethical approval was not obtained for the publication of this case report as this does not involve sharing of the personal details of the patient. Consent for publication Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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