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BARTTER'S SYNDROME PRESENTING DURING PREGNANCY RESULTS OF AMILORIDE THERAPY
Author(s) -
Stokes G. S.,
Andrews B. S.,
Hagon Elizabeth,
Thornell I. R.,
Palmer A. A.,
Posen S.
Publication year - 1974
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1974.tb70838.x
Subject(s) - bartter's syndrome , bartter syndrome , medicine , endocrinology , gitelman syndrome , amiloride , aldosterone , spironolactone , hypokalemia , hypomagnesemia , sodium , materials science , magnesium , metallurgy , chemistry , organic chemistry
A 22‐year‐old woman, pregnant for three months, presented with a history of episodic lower limb weakness for seven months, culminating in a severe attack of paraparesis and dysarthria. The serum potassium level was 2·2 mEq/l. and the serum creatine phosphokinase level was greatly increased. The detection of increased plasma renin activity and urinary aldosterone excretion suggested the diagnosis of Bartter's syndrome, which was confirmed by demonstrating the presence of juxtaglomerular hyperplasia in renal biopsy sections. After parturition, urinary aldosterone excretion fell, but hypokalaemia and hyperreninaemia persisted. Administration of amiloride, 10 mg per day, restored potassium balance and has been shown to constitute a useful alternative to oral potassium supplementation in controlling the hypokalaemia of this disorder. The unusual features of this case of Bartter's syndrome were the late onset, the severity of the hypokalaemic myopathy, the lack of generalized impairment in renal function and the association, apparently fortuitous, with pregnancy.