Bartter's syndrome with hyperplasia of renomedullary cells: successful treatment with indomethacin.
During treatment with indomethacin in a patient with Bartter's syndrome, hypokalemia, high plasma renin concentration, hyperaldosteronism and decreased sensitivity to angiotensin infusion were corrected. A particular finding in the renal biopsy specimen was a marked hyperplasia of renomedullary interstitial cells which had characteristics similar to the cells known to produce renal prostaglandins. The hypothesis is formultated that the primary defect in this syndrome is related to hyperplasia of renomedullary interstitial cells and inappropriate release of renal prostaglandins giving rise to decreased sodium reabsorption, volume depletion and hypersecretion of renin and aldosterone.
D000328:Adult; D001477:Bartter Syndrome / Q000188:drug therapy* / Q000473:pathology / Q000652:urine; D001835:Body Weight / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006929:Hyperaldosteronism / Q000188:drug therapy*; D006965:Hyperplasia / Q000473:pathology*; D007008:Hypokalemia / Q000188:drug therapy; D007213:Indomethacin / Q000627:therapeutic use*; D007606:Juxtaglomerular Apparatus / Q000473:pathology*; D007678:Kidney Glomerulus / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D011188:Potassium / Q000652:urine; D011453:Prostaglandins / Q000096:biosynthesis; D012964:Sodium / Q000652:urine; D013148:Spironolactone / Q000627:therapeutic use
D011453:Prostaglandins; D013148:Spironolactone; D012964:Sodium; D011188:Potassium; D007213:Indomethacin