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Case report: heavy metal burden presenting as Bartter syndrome

Walter J Crinnion1, Jessica Q Tran

  • 1Environmental Medicine Program, Southwest College of Naturopathic Medicine, Tempe, AZ, USA.

Alternative Medicine Review : a Journal of Clinical Therapeutic
|January 4, 2011
PubMed

Insights

Meso-2,3-dimercaptosuccinic acid (DMSA) treatment effectively reduced heavy metal burden in an infant with Bartter syndrome. This intervention improved the child's weight and length percentiles, suggesting a potential therapeutic benefit.

Area of Science:

  • Pediatric toxicology
  • Environmental medicine
  • Genetics

Background:

  • Maternal heavy metal exposure during gestation or lactation may cause Bartter syndrome and developmental issues in infants.
  • Genetic testing for Bartter syndrome was negative in the patient.

Observation:

  • An 11-month-old infant presented with Bartter syndrome and failure to thrive.
  • The infant had elevated levels of lead, beryllium, copper, mercury, and cadmium.
  • The mother's history of stained glass assembly was identified as a potential source of exposure.

Findings:

  • Treatment with meso-2,3-dimercaptosuccinic acid (DMSA) significantly reduced the infant's heavy metal body burden.
  • Following DMSA treatment, the patient experienced substantial weight gain and improved length percentiles.
  • The child's growth trajectory improved from below the 5th percentile to within the 5th-10th percentiles for weight and length.

Implications:

  • This case suggests DMSA may be a beneficial treatment for heavy metal toxicity in infants diagnosed with Bartter syndrome.
  • Early identification and chelation therapy can potentially mitigate adverse developmental outcomes associated with heavy metal exposure in infants.
  • Highlights the importance of considering environmental exposures in the etiology of pediatric conditions.
Abstract

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