Acquired bartter syndrome due to streptomycin

Nagaraju, Shankar Prasad (2014) Acquired bartter syndrome due to streptomycin. Nephrology Dialysis Transplantation, 29 (Supl-3). pp. 69-70.

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Abstract

Introduction and Aims: Bartter syndrome is an autosomal recessive renal tubular disorder characterized by hypokalemia, metabolic alkalosis, hypocalcaemia, hypomagnesaemia and hypercalciuria. Pseudo- Bartters/acquired Bartters syndrome has been commonly reported with diuretic abuse and laxative abuse. Among aminoglycosides, it has been described with gentamycin in few case reports.We report a case with similar conglomeration of electrolyte imbalance, but in an unusual setting with streptomycin. Methods: Case report Results: A 74 year old lady who is a known case of diabetes mellitus, hypertension, and hypothyroidism was recently found to have tubercular pleural effusion. She was started on antituberculous treatment which included streptomycin. Two weeks later, she developed convulsions and involuntary movements. On evaluation, she had hypokalemia, hypomagnesemia, hypocalcemia and metabolic alkalosis which persisted even after replacement therapy(Table 1). Urine analysis showed TTKG > 20 and 24 hour urine analysis confirmed the loss of potassium, magnesium and calcium in urine.After discontinuing streptomycin, she showed marked recovery over a week in her electrolyte abnormalities and alkalosis(Table 2). Conclusions: Ours is a rare case report of renal electrolyte wasting that mimicked Bartter syndrome and was induced by streptomycin.Thus while using aminoglycosides it should be kept in mind that they not only cause acute kidney injury but also can cause serious electrolyte disturbances in the form of pseudobartter’s syndrome.

Item Type: Article
Subjects: Medicine > KMC Manipal > Nephrology
Depositing User: KMC Manipal
Date Deposited: 19 Jun 2014 04:30
Last Modified: 19 Jun 2014 04:30
URI: http://eprints.manipal.edu/id/eprint/139815

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