Hypotensive response to angiotensin II analogue and angiotensin I converting enzyme inhibitor in pseudo-Bartter's syndrome.
We studied the effect of angiotensin II analogue (AII-A) and angiotensin I converting enzyme inhibitor (SQ 14,225) on blood pressure and the renin-angiotensin-aldosterone system in a patient with pseudo-Bartter's syndrome, who was a 26-year-old unmarried Japanese woman taking furosemide surreptitiously. The intravenous infusion of AII-A decreased blood pressure from 85/35 to 68/28 mmHg. This decrease in blood pressure was associated with an increment of plasma renin activity (PRA) and a decrement of plasma aldosterone concentration (PAC). Similarly, SQ 14,225 given orally decreased blood pressure to the same extent. An increment of PRA and a decrement of PAC were also observed. These results suggest that the renin-angiotensin system plays a considerable role in maintaining blood pressure in pseudo-Bartter's syndrome. Again, attention has to be paid to the possibility of surreptitious use of diuretics in an adult patient with persistent hypokalemic alkalosis, hyperactivity of the renin-angiotensin-aldosterone system and angiotensin II insensitivity simulating "true" Bartter's syndrome.
D015059:1-Sarcosine-8-Isoleucine Angiotensin II / Q000494:pharmacology*; D000328:Adult; D000804:Angiotensin II / Q000031:analogs & derivatives*; D000806:Angiotensin-Converting Enzyme Inhibitors; D001477:Bartter Syndrome / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects*; D002216:Captopril / Q000494:pharmacology*; D005260:Female; D005665:Furosemide / Q000009:adverse effects; D006801:Humans; D006929:Hyperaldosteronism / Q000503:physiopathology*; D011392:Proline / Q000031:analogs & derivatives*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000804:Angiotensin II; D005665:Furosemide; D015059:1-Sarcosine-8-Isoleucine Angiotensin II; D011392:Proline; D002216:Captopril