Abstract
A 13.5-year-old girl was referred for evaluation of hypokalaemia and growth retardation. She had felt fatigued for 2 years with polyuria, nocturia and episodic muscle cramps. Her apetite was poor and school performance declining. Physical examination revealed thin (26.5 kg), short (142.5 cm), normotensive (14/7.5 kPa) girl with delayed skeletal maturation (12 years). The serum K was 1.8, Na 135 and Co2 content 29 mmol/l, with mild hypomagnesemia (0.55 mmol/l). Polyuria was Pitressine resistant. Diagnosis of Bartter's syndrome was confirmed by increased reninemia (PRA 10.7 ng/ml) and urinary aldosterone elimination (15 ug/day), with juxtaglomerular cell hyperplasia in kidney tissue obtained at biopsy. She started treatment with potassium supplements (80 mmol/day), spironolactone (4 mg/kg/day) and propranolol (0.5 mg/kg/day). Response was satisfactory: hypokalemia was corrected, general condition improved, her appetite and linear growth increased (catch-up growth). Menarche occured at 16 years. Then we introduced Aspirin in a dose of 100 mg/kg/day. The girl remained hypokaliemic and adverse effects appeared: gastrointestinal upset and defect in coagulation mechanisms with epistaxis. Therefore Aspirin therapy was discontinued and conventional therapy reintroduced, with the same excellent results.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Radmanović, S., Jokanović, H., Nikezić, M. et al. Bartter's sydnrome in a 13.5-year-old girl: Growth characteristics and failure of Aspirin therapy. Pediatr Res 18, 1221 (1984). https://doi.org/10.1203/00006450-198411000-00124
Issue Date:
DOI: https://doi.org/10.1203/00006450-198411000-00124