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Captopril treatment in Bartter's syndrome
B Scherling1, H Verder, M D Nielsen
1Department of Pediatrics, Holbaek Hospital, Denmark.
Scandinavian Journal of Urology and Nephrology
|January 1, 1990
Summary
Bartter syndrome, a kidney disorder, can cause fatigue and excessive urination. Treatment with captopril and potassium supplements improved a young patient's symptoms when other therapies failed.
Area of Science:
- Nephrology
- Pediatric Endocrinology
- Internal Medicine
Background:
- Bartter syndrome is a rare genetic disorder affecting kidney salt reabsorption.
- It leads to electrolyte imbalances, including hypokalemia (low potassium) and metabolic alkalosis.
- Clinical presentation often includes polyuria (excessive urination) and lassitude (fatigue).
Observation:
- A 13-year-old female presented with significant lassitude and polyuria.
- Laboratory findings revealed elevated plasma renin and urinary prostaglandin excretion.
- Plasma aldosterone, urinary aldosterone, and blood pressure were within normal limits, consistent with Bartter syndrome.
Findings:
- Initial treatment with oral potassium yielded unsatisfactory results.
- Acetylsalicylic acid showed partial efficacy but was discontinued due to an allergic reaction.
- Combination therapy with an angiotensin converting enzyme (ACE) inhibitor, captopril, and oral potassium resulted in significant clinical and biochemical improvement.
Implications:
- This case highlights the complex management of Bartter syndrome in pediatric patients.
- ACE inhibitors, in conjunction with potassium supplementation, represent a viable therapeutic option.
- Understanding the role of prostaglandins and the renin-angiotensin-aldosterone system is crucial for managing Bartter syndrome.