Bartter's syndrome with normal chloride reabsorption during indomethacin treatment.
A 17-year-old male patient with Bartter's syndrome was admitted for renal function studies. This patient had persistent hypokalemia, first found at age 5; the diagnosis of Bartter's syndrome with renal hypersecretion of prostaglandins E2 and F2 alpha had been established at age 13. A congenital defect of chloride reabsorption was expected, but after 4 years of indomethacin treatment no such defect was found. Withdrawal of indomethacin for 1 week resulted in profound hypokalemia and the appearance of a chloride reabsorption defect, with an excessive urinary PGE2 and PGF2 alpha excretion, and a parallel decrease in plasma prostaglandin precursors. The cause of Bartter's syndrome in this patient seems to be renal hyperprostaglandinism.
D000293:Adolescent; D001477:Bartter Syndrome / Q000188:drug therapy / Q000378:metabolism*; D004573:Electrolytes / Q000097:blood; D005227:Fatty Acids / Q000097:blood; D006728:Hormones / Q000097:blood; D006801:Humans; D006929:Hyperaldosteronism / Q000378:metabolism*; D007213:Indomethacin / Q000627:therapeutic use*; D007668:Kidney / Q000378:metabolism; D007677:Kidney Function Tests; D008297:Male; D011453:Prostaglandins / Q000097:blood / Q000378:metabolism
D004573:Electrolytes; D005227:Fatty Acids; D006728:Hormones; D011453:Prostaglandins; D007213:Indomethacin