Bartter’s syndrome is a rare renal tubular disorder with an .. van der Vliet W, Claverie-Martín F. Enfermedad de Bartter neonatal diagnosticada. Bartter’s syndrome: evaluation of statural growth and metabolic profile. Síndrome . Objetivo: El síndrome de Bartter (SB) es una enfermedad rara, pero una de. Bartter syndrome with hypocalcemia is a type of Bartter syndrome (see this term) characterized by hypocalcemia, hypomagnesemia and hypoparathyroidism.
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On follow up, failure to thrive was observed, with an evolution for height and weight under percentile 3 based on the World Health Organization WHO child baartter charts. Open in a separate window.
Although the molecular study was not performed, he started indomethacin and potassium supplement, improving his appetite and weight. The infant was advised exclusive breastfeeding for 2. His older brother, also born preterm, had nephrocalcinosis and hypercalciuria attributed to prematurity and its complications.
Bartter syndrome with hypocalcemia is a type of Bartter syndrome see this term characterized by hypocalcemia, hypomagnesemia and hypoparathyroidism along with features of Henle’s loop dysfunction polyuria, hypokalemic alkalosis, increased levels of plasma renin and aldosterone, low blood pressure and vascular resistance to angiotensin II.
The tubular defect in Bartter syndrome cannot be corrected. However, there was no clear diagnosis for those findings.
J Pediatr ; 3: Potassium supplements were introduced at D GFR, glomerular filtration rate. Medullary nephrocalcinosis, a hallmark of pure TAL dysfunction, is rare. There are two distinct clinical presentations: Early treatment improves prognosis, in particular concerning growth and psychomotor development.
With the clinical diagnosis of Bartter syndrome, the child began therapy with increasing supplementation of potassium chloride, in order to normalise plasma potassium levels, to which was later added indomethacin.
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Detailed information Article for general public Svenska Afterwards, he was transferred and followed in a secondary hospital. The renal ultrasound at D3 was normal and at D36 was suggestive of macroscopic nephrocalcinosis both renal sinuses had hyper-reflected spots ; at 8 months medullary nephrocalcinosis was confirmed the medullary pyramids were hyperechoic, bilaterally, and cortical thickness was preserved with no signs of hydronephrosis.
Early treatment improves prognosis. Exact prevalence of Bartter syndrome with hypocalcemia is not known with very few patients so far described. The ABS is a rare entity but it should be suspected in any neonate with antenatal history of unexplained and rapidly increasing polyhydramnios in the late second trimester, that presents during the early neonatal period with polyuria and severe dehydration.
Clearly, this channel malfunction will cause an altered transport of sodium and chloride in the distal nephron.
The newborn had a 5-year-old sibling, born at 29 weeks. The ClC-Kb is located in the basolateral membrane of distal tubular cells and allows the passage of chloride from the cell into the bloodstream. The family history was thalassemia minor and atopy, with no consanguinity.
Kidney Int ;72 9: The combination of hyperaldosteronism and increased distal flow enhances potassium and hydrogen secretion, causing hypokalaemia and metabolic alkalosis. Unexplained polyhydramnios between 24 and 30 weeks of gestation, without apparent foetal or placental abnormalities should lead to the suspicion of this entity 3.
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Currently, he is 21 months old and continues on a potassium supplement, having stopped the sodium supplementation at 4 months old. Major derangements are severe dehydration, hyponatremia, hypochloremia, hypokalaemia and metabolic alkalosis. Pregnancy was complicated by severe polyhydramnios at 24 weeks, which led to hospitalization and therapeutic amniodrainage at 28 weeks of gestation.
Hyperaldosteronism will also stimulate potassium secretion, thus closing the pathogenic circle. Hypocalcaemia may be asymptomatic or associated with paresthesias, carpopedal spasm, and seizures. Prenatal diagnosis can be made by documenting high chloride content of the amniotic fluid and mutational analysis of genomic DNA extracted from cultured amniocytes obtained by amniocentesis 4,6.
Additional information Further information on this disease Classification s 4 Gene s 1 Other website s 0. Later on, short stature, failure to thrive, nephrocalcinosis and hypercalciuria were detected. The newborn developed polyuria, dehydration, electrolyte imbalances and metabolic alkalosis. Furthermore, nearly all ABS patients develop medullary nephrocalcinosis within the first month of life 1which was also observed by us. The resulting hypokalaemia will stimulate prostaglandin synthesis, which in turn will induce compensatory increases in the activity of the renin, angiotensin and adrenergic systems to maintain blood pressure.
In our patient, the diagnosis of ABS was suspected early due to the family history and pregnancy antecedents: Bartter syndrome with hypocalcemia is a very rare manifestation of autosomal dominant hypocalcemia ADH; see this term.