ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2021 and some content may be unavailable. To unlock all content for 2021, please visit the archives.

Abstract: PO1121

Late-Onset Bartter Syndrome

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

  • 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Alex, Mica, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
  • Elharrif, Khalid, Kern Medical Center, Bakersfield, California, United States
  • Al-Taweel, Omar S., The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
  • Greti, Petersen, Kern Medical Center, Bakersfield, California, United States
  • Kassem, Hania, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
Introduction

Bartter syndrome (BS) is an autosomal recessive disorder that results from mutations in sodium chloride reabsorption in the thick ascending loop of Henle. The age of onset is usually late childhood or early adulthood and it is rare to have the disease onset in adulthood. We are presenting a rare case of late-onset Bartter syndrome.

Case Description

A 55-year-old female with PMH of supraventricular tachycardia was admitted to the hospital with chest pain and palpitations. She had a history of multiple hospital admissions in the past with hypotension and electrolyte abnormalities. She denied any history of diarrhea or recent use of diuretics or laxatives. Initial Blood pressure was 100/60 mmHg and HR was 100 bpm. The lab results are summarized in Table A. CT scan of the pelvis showed bilateral nephrocalcinosis. She received IV fluid resuscitation, magnesium and potassium supplementation and spironolactone with subsequent improvement of her symptoms.

Discussion

BS is classified into five types based on the genetic characters of the disease. Type 3 is associated with classic BS. The chromosomal mutations are associated with a variable degree of disease severity. The mutation types have been identified as large deletions, missense and nonsense mutations. This patient likely has type 3 BS but her mutation type could be a missense mutation so that only one or few amino acids are altered leading to late-onset of her syndrome. The standard treatment is electrolyte repletion. Specific treatment therapy continues to be an ongoing source of research. ACE inhibitors and spironolactone can play a role in blocking the RAAS system. NSAIDs can be used to suppress the high level of PGE2 associated with the disease.