[The Bartter-like syndrome in 2 twins]

We present a case of two twins, admitted to our department at the age of 9 years and 9 months for poor stature-ponderal growth. Hematochemical tests showed hypokalemia, hypomagnesemia, metabolic alkalosis, renin increase, normal aldosterone values, hypocalciuria. Arterial pressure values were normal in both patients. Renal hypokalemia with metabolic alkalosis was hypothesized and therefore tubular functions during diuresis induced by intravenous 5% dextrose in water were evaluated and fractionated tubular resorption values of chlorides were identified. The two patients presented many characteristics typical of Bartter syndrome (suggestive facies, short stature, hypokalemia, metabolic alkalosis, renin increase, decreased chloride resorption) and of Gitelman syndrome (late onset, few symptoms, hypomagnesemia, hypocalciuria, normal renal concentration). The definition "Bartter-like syndrome" seems to be more suitable for these patients, since it can include all the clinical characteristics and biochemical anomalies observed.