Skip to main content
Log in

Concealed administration of frusemide simulating Bartter syndrome in a 4.5-year-old boy

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

A 4.5-year-old boy was admitted to three different hospitals because of a tendency towards dehydration and polyuria, along with normal blood pressure, hypochloraemia, hypokalaemia, metabolic alkalosis and an impaired urinary concentrating ability. A renal biopsy failed to reveal juxtaglomerular hyperplasia. The clinical and laboratory findings failed to improve despite supplementation with potassium chloride and treatment with indomethacin. The urine was found to contain frusemide. The parents denied any drug administration to the boy. The child is now doing well more than 1 year after separation from his mother. Since ingestion of diuretic cannot be differentiated from true Bartter syndrome by blood and urinary electrolyte measurements alone, a diuretic screen is warranted in children with findings consistent with Bartter syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Bettinelli A, Bianchetti MG, Girandin E, Caringella A, Cecconi M, Claris Appiani A, Pavanello L, Gastaldi R, Isimbaldi C, Lama G, Marchesoni C, Matteucci C, Patriarca P, Di Natale B, Setzu C, Vitucci P (1992) Use of calcium excretion values to distinguish two forms of primary renal tubular hypokalemic alkalosis: Bartter and Gitelman syndromes. J Pediatr 120: 38–43

    Google Scholar 

  2. Colussi G, Rombolà G, Airaghi C, De Ferrari ME, Minetti L (1992) Pseudo-Bartter syndrome from surreptitious diuretic intake: differential diagnosis with true Bartter's syndrome. Nephrol Dial Transplant 7: 896–901

    Google Scholar 

  3. Rogers D, Tripp J, Bentovim A, Robinson A, Berry D, Goulding R (1976). Non-accidental child poisoning: an extended syndrome of child abuse. BMJ 1: 793–796

    Google Scholar 

  4. Chan DA, Salced JR, Aktins DW, Ruley EJ (1986) Münchausen syndrome by proxy: a review and a case study. J Pediatr Psychol 11: 71–80

    Google Scholar 

  5. Meadow RS (1985) Management of Münchausen syndrome by proxy. Arch Dis Child 60: 385–393

    Google Scholar 

  6. Rosenberg DA (1987) Web of deceit: a literature review of Münchausen syndrome by proxy. Child Abuse Negl 11: 547–563

    Google Scholar 

  7. Peschel RE, Peschel E (1989) What physicians have in common with Sherlock Holmes. J R Soc Med 82: 33–36

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

D'Avanzo, M., Santinelli, R., Tolone, C. et al. Concealed administration of frusemide simulating Bartter syndrome in a 4.5-year-old boy. Pediatr Nephrol 9, 749–750 (1995). https://doi.org/10.1007/BF00868731

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00868731

Key words

Navigation