Pediatric Nephrology

, Volume 2, Issue 2, pp 205–209

Growth from birth to adulthood in a patient with the neonatal form of bartter syndrome

  • W. Proesmans
  • G. Massa
  • M. Vanderschueren-Lodeweyckx
Original Article


Growth from birth to the age of 19 years was studied in a patient with the neonatal form of Bartter syndrome. The initial modes of therapy (extra fluid, potassium supplements and triamterene) resulted in satisfactory but not optimal growth. Treatment with spironolactone together with potassium led to impressive catch-up growth. When the patient reached the age of 9 years, indomethacin therapy was started, which resulted in a second growth acceleration and was also accompanied by a significant reduction of both polyuria and hypercalciuria. Puberty developed normally, menarche occurred at 12 years 4 months and a normal adult height of 162 cm was reached at the age of 14 years. Treatment with prostaglandin synthetase inhibitors seems to be the best therapy for children with the neonatal form of Bartter syndrome.

Key words

Bartter syndrome Polyhydramnios Hypercalciuria Spironolactone Indomethacin Growth retardation Catch-up growth 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bartter FC, Pronove P, Gill JR, MacCardle RC (1962) Hyperplasia of the juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis. Am J Med 33: 811–828Google Scholar
  2. 2.
    Dillon MJ, Shah V, Mitchell MD (1979) Bartter's syndrome: 10 cases in childhood. Q J Med 191: 429–446Google Scholar
  3. 3.
    Fanconi A, Schachenmann G, Nussli R, Prader A (1971) Chronic hypokalaemia with growth retardation, normotensive hyperrenin-hyperaldosteronism (Bartter's syndrome), and hypercalciuria. Helv Paediatr Acta 26: 144–163Google Scholar
  4. 4.
    Marlow N, Chiswick ML (1982) Neonatal Bartter's syndrome, indomethacin and necrotising enterocolitis. Acta Paediatr Scand 71: 1031–1032Google Scholar
  5. 5.
    Massa G, Proesmans W, Devlieger H, Vandenberghe K, Van Assche A, Eggermont E (1987) Electrolyte composition of the amniotic fluid in the neonatal form of Bartter syndrome. Eur J Obstet Gynecol 24: 335–340Google Scholar
  6. 6.
    McCredie DA, Rotenberg E, Williams AL (1974) Hypercalciuria in potassium-losing nephropathy: a variant of Bartter's syndrome. Aust Paediatr J 10: 286–295Google Scholar
  7. 7.
    Ohlsson A, Sieck U, Cumming W, Akhtar M, Serenius F (1984) A variant of Bartter's syndrome: Bartter's syndrome associated with hydramnios, prematurity, hypercalciuria and nephrocalcinosis. Acta Paediatr Scand 73: 868–874Google Scholar
  8. 8.
    Proesmans W, Devlieger H, Van Assche A, Eggermont E, Vandenberghe K, Lemmens F, Sieprath P, Lijnen P (1985) Bartter syndrome in two siblings: antenatal and neonatal observations. Int J Pediatr Nephrol 6: 63–70Google Scholar
  9. 9.
    Robson WL, Arbus GS, Balfe JW (1979) Bartter's syndrome: differentiation into two clinical groups. Am J Dis Child 133: 636–638Google Scholar
  10. 10.
    Rodrigues Pereira R, Hasaart T (1982) Hydramnios and observations in Barrter's syndrome. Acta Gynecol Scand 61: 477–478Google Scholar
  11. 11.
    Seyberth HW, Rascher W, Schweer H, Kuhl PG, Mehls O, Schärer K (1985) Congenital hypokalemia with hypercalciuria in preterm infants: a hyperprostaglandinuric tubular syndrome different from Bartter syndrome. J Pediatr 107: 694–701Google Scholar
  12. 12.
    Sieck UV, Ohlsson A (1984) Fetal polyuria and hydramnios associated with Bartter's syndrome. Obstet Gynecol 63: 22S-24SGoogle Scholar
  13. 13.
    Simopoulos AP, Bartter FC (1979) Growth characteristics and factors influencing growth in Bartter's syndrome. J Pediatr 81: 56–65Google Scholar
  14. 14.
    Simopoulos AP (1979) Growth characteristics in patients with Bartter syndrome. Nephron 23: 130–135Google Scholar
  15. 15.
    Cannon PJ, Leeming JM, Sommers SC, Winters RW, Laragh JH (1968) Juxtaglomerular cell hyperplasia and secondary hyperaldosteronism (Bartter's syndrome): a reevaluation of the pathophysiology. Medicine 47: 107–131Google Scholar
  16. 16.
    Floret D, David M, Roux A, Hage GN, Teyssier G (1979) Syndrome de Bartter: effects à long terme de l'indométhacine sur la croissance. Nouv Presse Méd 8: 17–21Google Scholar
  17. 17.
    James T, Holland NH, Preston D (1975) Bartter syndrome: typical facies and normal plasma volume. Am J Dis Child 129: 1205–1207Google Scholar
  18. 18.
    Lechacz G, Arbus GS, Balfe FW, Wolff ED, Robson L (1979) Effect of ibuprofen on growth in a child with Bartter syndrome. J Pediatr 95: 319–320Google Scholar
  19. 19.
    Littlewood JM, Lee MR, Meadow SR (1978) Treatment of Bartter's syndrome in early childhood with prostaglandin synthetase inhibitors. Arch Dis Child 53: 43–48Google Scholar
  20. 20.
    Rodriguez-Soriano J, Vallo A, Oliveros R (1978) Bartter's syndrome presenting with features resembling renal tubular acidosis. Helv Paediatr Acta 33: 141–151Google Scholar
  21. 21.
    Trygstad CW, Mangos JA, Bloodworth JMB, Lobeck CC (1969) A sibship with Bartter's syndrome: failure of total adrenalectomy to correct the potassium wasting. Pediatrics 44: 234–242Google Scholar
  22. 22.
    Proesmans W, Binda Ki Muaka P, Monnens L (1977) Indomethacin therapy in Bartter syndrome. Acta Paediatr Belg 30: 31–36Google Scholar
  23. 23.
    Lubchenco LO, Hansman C, Boyd E (1966) Intrauterine growth in length and head circumference as estimated from life births at gestational ages from 26 to 42 weeks. Pediatrics 37: 403–408Google Scholar
  24. 24.
    Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, weight velocity, and stages of puberty. Arch Dis Child 51: 170–179Google Scholar
  25. 25.
    Tanner JM (1962) Growth at adolescene, 2nd edn. Blackwell, OxfordGoogle Scholar
  26. 26.
    Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press StanfordGoogle Scholar
  27. 27.
    Lijnen P, Amery A, Fagard R, Corrol P (1978) Direct radioimmunoassay of plasma aldosterone in normal subjects. Clin Chim Acta 84: 305–314Google Scholar
  28. 28.
    Ladegaard-Pederson HJ (1972) Measurement of extra cellular volume and renal clearance by a single injection of inulin. Scand J Clin Lab Invest 29: 145–153Google Scholar
  29. 29.
    Arant BS, Brackett NC, Young RB, Still WJS (1970) Case studies of siblings with juxtaglomerular hyperplasia and secondary aldosteronism associated with severe azotemia and renal rickets — Bartter's syndrome or diesease? Pediatrics 46: 344–361Google Scholar
  30. 30.
    Camacho AM, Blizzard RM (1962) Congenital hypokalemia of propable renal origin. Am J Dis Child 103: 43–63Google Scholar
  31. 31.
    Manigne P (1983) Syndrome de Bartter. In: Royer P (ed) Néphrologie pédiatrique. Flammarion, Paris, pp 63–66Google Scholar
  32. 32.
    Norby L, Flamenbaum W, Lentz R, Ramwell P (1976) Prostaglandins and aspirin therapy in Bartter's syndrome. Lancet II: 604–606Google Scholar
  33. 33.
    Royer P, Delaitre R, Mathieu H, Gabilan JC, Raynaud C, Pasqualini JR, Gerbeaux S, Habib R (1964) L'hypokaliémie chronique idiopathique avec hyperkaliurie de l'enfant. Rev Fr Etud Clin Biol 9: 61–87Google Scholar
  34. 34.
    Fichman MP, Telfer N, Zia P, Speckart P, Golub M, Rude R (1976) Role of prostaglandins in the pathogenesis of Bartter's syndrome. Am J Med 60: 785–797Google Scholar

Copyright information

© IPNA 1988

Authors and Affiliations

  • W. Proesmans
    • 1
  • G. Massa
    • 1
  • M. Vanderschueren-Lodeweyckx
    • 1
  1. 1.Department of PaediatricsUniversity Hospital GasthuisbergLeuvenBelgium

Personalised recommendations