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NDT Advance Access originally published online on November 5, 2008
Nephrology Dialysis Transplantation 2009 24(2):667-669; doi:10.1093/ndt/gfn600
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


A syndrome resembling Bartter's syndrome in sarcoidosis

Tung-Min Yu1, Shih-Hua Lin6, Chuang Ya-Wen1, Mei-Chin Wen4, Yi-Hsing Chen3, Chi-Hung Cheng1,5, Cheng-Hsu Chen1, Chung-Shi Chin2 and Kuo-Hsiung Shu1,5

1 Division of Nephrology 2 Division of Chest 3 Division of Allergy and Immunology, Department of Internal Medicine 4 Department of Pathology, Taichung Veterans General Hospital 5 Chung-Shan Medical University, Taichung 6 Division of Nephrology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan

Correspondence and offprint requests to: Kuo-Hsiung Shu, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Chung-Kang Road, Sec. 3, Taichung, Taiwan. Tel: +886-4-23592525, Ext. 3040; Fax: +886-4-23594980; E-mail: yu5523{at}yahoo.com.tw



  Abstract

Acquired Bartter-like syndrome, albeit rare, has not been reported to be associated with sarcoidosis. We describe the case of a 32-year-old male patient who presented with progressive muscular weakness of both lower extremities. Profound hypokalaemia associated with renal (K+) wasting, bilateral nephrocalcinosis and high plasma renin activity resembled Bartter's syndrome (BS). Both mediastinal lymph node and renal biopsy demonstrated sarcoidosis with non-caseating granuloma. Genetic testing responsible for hereditary BS or Gitelman's syndrome (GS) was negative. Hypokalaemia was well controlled with the administration of spironolactone with oral steroids and KCl. Early recognition and prompt treatment of sarcoidosis-associated Bartter-like syndrome avoids unnecessary complications.

Keywords: acquired Bartter-like syndrome; hypokalaemia; sarcoidosis

Received for publication: 29. 2.08
Accepted in revised form: 1.10.08


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