Abstract
Factitious-Bartter's syndrome due to surreptitious diuretic administration may be difficult to recognize. Serum urate has been constantly reported to be elevated in factitious-Bartter's syndrome but is seldom increased in true-Bartter's syndrome. A 33-year-old woman with a serum urate level of 10.4 mg/dl and diminished fractional excretion of uric acid satisfied the criteria for Bartter's syndrome, including hypokalemic alkalosis, hyperreninemia, aldosteronism, normal blood pressure, insensitivity to the pressor effects of angiotensin infusion and hyperplasia of the juxtaglomerular apparatus. Indomethacin treatment normalized these metabolic derangements except increased serum urate. A plasma screening test for furosemide was positive. In two infants with Bartter's syndrome plasma bicarbonate concentrations were brought to normal levels with indomethacin but serum urate failed to significantly change. These data indicate that systemic alkalosis does not markedly influence serum urate. Persistent hyperuricemia after normalization of the functional abnormalities of Bartter's syndrome may be of diagnostic aid to factitious-Bartter's syndrome caused by diuretic ingestion.
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Jiménez, M., Mateos, F., Puig, J. et al. HYPERURICEMIA AS POSSIBLE DIAGNOSTIC AID to FACTITIOUS-BARTTER'S SYNDROME: 95. Pediatr Res 19, 759 (1985). https://doi.org/10.1203/00006450-198507000-00115
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DOI: https://doi.org/10.1203/00006450-198507000-00115