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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Diuretic|Diuretic abuse]]'''
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Diuretic|Diuretic abuse]]'''
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*Diuretic abuse should be considered in all patients with unexplained hypokalemia and metabolic alkalosis.<ref name="pmid7091169">{{cite journal| author=Jamison RL, Ross JC, Kempson RL, Sufit CR, Parker TE| title=Surreptitious diuretic ingestion and pseudo-Bartter's syndrome. | journal=Am J Med | year= 1982 | volume= 73 | issue= 1 | pages= 142-7 | pmid=7091169 | doi=10.1016/0002-9343(82)90941-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7091169  }} </ref><ref name="pmid1328936">{{cite journal| author=Colussi G, Rombolà G, Airaghi C, De Ferrari ME, Minetti L| title=Pseudo-Bartter's syndrome from surreptitious diuretic intake: differential diagnosis with true Bartter's syndrome. | journal=Nephrol Dial Transplant | year= 1992 | volume= 7 | issue= 9 | pages= 896-901 | pmid=1328936 | doi=10.1093/ndt/7.9.896 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1328936  }} </ref><ref name="pmid3023152">{{cite journal| author=Sasaki H, Kawasaki T, Yamamoto T, Ninomiya H, Ono J, Yamamoto T | display-authors=etal| title=[Pseudo-Bartter's syndrome induced by surreptitious ingestion of furosemide to lose weight: a case report and possible pathophysiology]. | journal=Nihon Naibunpi Gakkai Zasshi | year= 1986 | volume= 62 | issue= 8 | pages= 867-81 | pmid=3023152 | doi=10.1507/endocrine1927.62.8_867 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3023152  }} </ref>
*[[Diuretic|Diuretic abuse]] should be considered in all patients with unexplained [[hypokalemia]] and [[metabolic alkalosis]].<ref name="pmid7091169">{{cite journal| author=Jamison RL, Ross JC, Kempson RL, Sufit CR, Parker TE| title=Surreptitious diuretic ingestion and pseudo-Bartter's syndrome. | journal=Am J Med | year= 1982 | volume= 73 | issue= 1 | pages= 142-7 | pmid=7091169 | doi=10.1016/0002-9343(82)90941-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7091169  }} </ref><ref name="pmid1328936">{{cite journal| author=Colussi G, Rombolà G, Airaghi C, De Ferrari ME, Minetti L| title=Pseudo-Bartter's syndrome from surreptitious diuretic intake: differential diagnosis with true Bartter's syndrome. | journal=Nephrol Dial Transplant | year= 1992 | volume= 7 | issue= 9 | pages= 896-901 | pmid=1328936 | doi=10.1093/ndt/7.9.896 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1328936  }} </ref><ref name="pmid3023152">{{cite journal| author=Sasaki H, Kawasaki T, Yamamoto T, Ninomiya H, Ono J, Yamamoto T | display-authors=etal| title=[Pseudo-Bartter's syndrome induced by surreptitious ingestion of furosemide to lose weight: a case report and possible pathophysiology]. | journal=Nihon Naibunpi Gakkai Zasshi | year= 1986 | volume= 62 | issue= 8 | pages= 867-81 | pmid=3023152 | doi=10.1507/endocrine1927.62.8_867 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3023152  }} </ref>
*Sometimes parents or caregivers administer diuretics in infants.
*Sometimes parents or caregivers administer [[diuretics]] in infants.
*It is hard to differentiate diuretic abuse from Bartter syndrome by blood and urinary electrolyte measurements. A diuretic screen is warranted.<ref name="pmid8747119">{{cite journal| author=D'Avanzo M, Santinelli R, Tolone C, Bettinelli A, Bianchetti MG| title=Concealed administration of frusemide simulating Bartter syndrome in a 4.5-year-old boy. | journal=Pediatr Nephrol | year= 1995 | volume= 9 | issue= 6 | pages= 749-50 | pmid=8747119 | doi=10.1007/BF00868731 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8747119  }} </ref>
*It is hard to differentiate [[diuretic|diuretic abuse]] from [[Bartter syndrome]] by blood and urinary electrolyte measurements. A [[diuretic]] screen is warranted.<ref name="pmid8747119">{{cite journal| author=D'Avanzo M, Santinelli R, Tolone C, Bettinelli A, Bianchetti MG| title=Concealed administration of frusemide simulating Bartter syndrome in a 4.5-year-old boy. | journal=Pediatr Nephrol | year= 1995 | volume= 9 | issue= 6 | pages= 749-50 | pmid=8747119 | doi=10.1007/BF00868731 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8747119  }} </ref>
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| style="padding: 5px 5px; background: #DCDCDC;" |'''Cyclical vomiting'''
| style="padding: 5px 5px; background: #DCDCDC;" |'''Cyclical vomiting'''

Revision as of 10:54, 31 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Tayyaba Ali, M.D.[2]

Overview

Differentiating Bartter syndrome from other Diseases

Bartter syndrome diagnosis should be differentiated from other diseases manifesting with hypokalemia and hypochloremic metabolic alkalosis.[1]

Disease Findings
Gitelman syndrome
Diuretic abuse
Cyclical vomiting
Hyperprostaglandin E syndrome
Familial hypomagnesemia with hypercalciuria/nephrocalcinosis
Cystic fibrosis
Gullner syndrome - Familial hypokalemic alkalosis with proximal tubulopathy
Mineralocorticoid excess
Activating mutations of the CaSR calcium-sensing receptor
Hypomagnesemia
Congenital chloride diarrhea
Hypochloremic alkalosis
Hypokalemia

References

  1. Gitelman HJ, Graham JB, Welt LG (1966). "A new familial disorder characterized by hypokalemia and hypomagnesemia". Trans Assoc Am Physicians. 79: 221–35. PMID 5929460.
  2. Scognamiglio R, Negut C, Calò LA (2007). "Aborted sudden cardiac death in two patients with Bartter's/Gitelman's syndromes". Clin Nephrol. 67 (3): 193–7. doi:10.5414/cnp67193. PMID 17390745.
  3. Urbanová M, Reiterová J, Stěkrová J, Lněnička P, Ryšavá R (2011). "DNA analysis of renal electrolyte transporter genes among patients suffering from Bartter and Gitelman syndromes: summary of mutation screening". Folia Biol (Praha). 57 (2): 65–73. PMID 21631963.
  4. Jamison RL, Ross JC, Kempson RL, Sufit CR, Parker TE (1982). "Surreptitious diuretic ingestion and pseudo-Bartter's syndrome". Am J Med. 73 (1): 142–7. doi:10.1016/0002-9343(82)90941-x. PMID 7091169.
  5. Colussi G, Rombolà G, Airaghi C, De Ferrari ME, Minetti L (1992). "Pseudo-Bartter's syndrome from surreptitious diuretic intake: differential diagnosis with true Bartter's syndrome". Nephrol Dial Transplant. 7 (9): 896–901. doi:10.1093/ndt/7.9.896. PMID 1328936.
  6. Sasaki H, Kawasaki T, Yamamoto T, Ninomiya H, Ono J, Yamamoto T; et al. (1986). "[Pseudo-Bartter's syndrome induced by surreptitious ingestion of furosemide to lose weight: a case report and possible pathophysiology]". Nihon Naibunpi Gakkai Zasshi. 62 (8): 867–81. doi:10.1507/endocrine1927.62.8_867. PMID 3023152.
  7. D'Avanzo M, Santinelli R, Tolone C, Bettinelli A, Bianchetti MG (1995). "Concealed administration of frusemide simulating Bartter syndrome in a 4.5-year-old boy". Pediatr Nephrol. 9 (6): 749–50. doi:10.1007/BF00868731. PMID 8747119.
  8. Veldhuis JD, Bardin CW, Demers LM (1979). "Metabolic mimicry of Bartter's syndrome by covert vomiting: utility of urinary chloride determinations". Am J Med. 66 (2): 361–3. doi:10.1016/0002-9343(79)90566-7. PMID 425977.


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