engleski

Bartters syndrome - case report

Aim. Forty years old female suffered for long term weakness, persistent unexplained hypokalemia, metabolic alkalosis and cryoglobulinemia(Table 1).The serum value of aldosterone was in the normal range.According to hyperreninemia, clinical suspicion of Bartters syndrome was established and percutaneous renal biopsy was performed.The patient was treated with spironolactone, nonsteroid antinflammatory drug and oral potassium supplementation. Methods. Percutaneous renal biopsy tissue specimen was prepared in standard manner for rutine light and ultrastructural analysis. Results. All glomeruli shopwed global hypertrophy of juxtaglomerular apparatus.Except a mild focal mesangial proliferation, other glomerular structures as well as tubules, interstitium and blood vessels were normal(Figures 1 and 2).On semithin section only one glomerulus was found and cut to show juxtaglomerular apparatus.Ultrastructurally, numorous dense core neurosecretory granules and progranules were found in the cytoplasm of juxtaglomerular cells(Figure 3). Conclusion. Although Bartter syndrome is rare, the diagnosis should be entertained in normotensive patient with unexplained persistent hypokalemia and hyperreninemia and confirmed morphologically as hyperplasia and hypergranularity of juxtaglomerular cells.

Bartters syndrome; metabolic alkalosis

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