Bartter syndrome presenting as poor weight gain and abdominal mass in an infant.
Bartter syndrome, a group of disorders that encompasses multiple genetic defects with similar clinical presentation, has been divided into six different genotypes, according to different genetic defects, and into three main clinical variants (or phenotypes). Classic laboratory findings in all variants include hypochloremia, hypokalemia, and metabolic alkalosis with excessive excretion of chloride and potassium. Classic Bartter syndrome, neonatal Bartter syndrome, and Gitelman syndrome are the three main clinical variants. Classic Bartter syndrome and neonatal Bartter syndrome have defects in genes that affect transport channels in the ascending loop of Henle, where as in Gitleman syndrome the defect occurs in the transport channels of the distal convoluted tubule. Classic Bartter syndrome and neonatal Bartter syndrome have similar presenting symptoms, potential outcomes, and treatment, but different ages at presentation. Gitelman syndrome, a more benign condition than the other clinical variants, has the classic hallmark finding of hypomagnesemia and low to normal excretion of calcium. This differentiates it from the classic and neonatal variants of the disease. With early diagnosis and proper treatment, Bartter syndrome has a good prognosis. But failure to identify it can lead to tubulointerstitial nephritis and renal failure. We present a case of a 6-month-old boy with Bartter syndrome who presented with poor weight gain and an abdominal mass.
Heffernan
Annie
A
Department of Pediatrics, University of South Florida, Tampa General Hospital, Tampa, Florida 33611, USA. aheffern@health.usf.edu
Steffensen
Thora S
TS
Gilbert-Barness
Enid
E
Perlman
Sharon
S
D000005:Abdomen / Q000002:abnormalities*; D000471:Alkalosis / Q000178:diet therapy / Q000235:genetics / Q000378:metabolism; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001477:Bartter Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D053579:Gitelman Syndrome / Q000235:genetics / Q000378:metabolism; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007008:Hypokalemia / Q000178:diet therapy / Q000235:genetics / Q000378:metabolism; D007213:Indomethacin / Q000627:therapeutic use; D007223:Infant; D008297:Male; D011189:Potassium Chloride / Q000627:therapeutic use; D011899:Ranitidine / Q000627:therapeutic use; D017673:Sodium Chloride, Dietary / Q000627:therapeutic use; D013577:Syndrome; D016896:Treatment Outcome; D015430:Weight Gain
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006635:Histamine H2 Antagonists; D017673:Sodium Chloride, Dietary; D011189:Potassium Chloride; D011899:Ranitidine; D007213:Indomethacin