Metabolic mimicry of Bartter's syndrome by covert vomiting: utility of urinary chloride determinations.
Bartter's syndrome characteristically exhibits the constellation of hypokalemic alkalosis with moderate kaliuresis, normotensive hyperreninemia, hyperaldosteronism, urinary hyperexcretion of prostaglandin E (PGE) and vascular hyporesponsivity to pressor agents. We describe precise biochemical mimicry of these metabolic abnormalities in a patient with surreptitious repetitive vomiting, in whom simple urinary chloride excretion data subsequently excluded the diagnosis of Bartter's syndrome.
D000328:Adult; D001477:Bartter Syndrome / Q000175:diagnosis* / Q000652:urine; D002712:Chlorides / Q000652:urine*; D003951:Diagnostic Errors; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis*; D008297:Male; D011188:Potassium / Q000652:urine; D012965:Sodium Chloride / Q000008:administration & dosage; D014839:Vomiting / Q000175:diagnosis* / Q000652:urine
D002712:Chlorides; D012965:Sodium Chloride; D011188:Potassium