A Patient with Cystinosis Presenting Like Bartter Syndrome and Review of Literature

Pelin Ertan; Havva Evrengul; Serkan Ozen; Sinan Emre

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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A Patient with Cystinosis Presenting Like Bartter Syndrome and Review of Literature

Author(s):

Pelin Ertan^1,*,

Havva Evrengul²,

Serkan Ozen³,

Sinan Emre⁴

IJ Pediatrics:Vol. 22, issue 4; 543-546

Published online:Feb 18, 2012

Article type:Case Report

Received:May 04, 2011

Accepted:Mar 10, 2012

How to Cite:Pelin ErtanHavva EvrengulSerkan OzenSinan EmreA Patient with Cystinosis Presenting Like Bartter Syndrome and Review of Literature.Iran J Pediatr.22(4):543-546.

Abstract

Background: Nephropathic cystinosis is an autosomal recessively inherited metabolic disorder presenting with metabolic acidosis, Fanconi syndrome and renal failure.
Case Presentation: We present a 6-year-old girl with severe growth failure, hyponatremia and hypokalemia. Her parents were 4th degree relatives. Two relatives were diagnosed as end stage renal failure. She also had persistant hypokalemic hypochloremic metabolic alkalosis. Her renal function was normal at presentation. She was thought to have Bartter syndrome with supporting findings of elevated levels of renin and aldosterone with normal blood pressure, and hyperplasia of juxtaglomerular apparatus. Her metabolic alkalosis did not resolve despite supportive treatment. At 6th month of follow-up proteinuria, glucosuria and deterioration of renal function developed. Diagnosis of cystinosis was made with slit lamp examination and leukocyte cystine levels. At 12th month of follow-up her metabolic alkalosis has converted to metabolic acidosis.
Conclusion: In children presenting with persistant metabolic alkalosis, with family history of renal failure, and parental consanguinity, cystinosis should always be kept in mind as this disease is an important cause of end stage renal failure which may have features mimmicking Bartter syndrome.

Keywords

Nephropathic Cystinosis

Bartter Syndrome

Children

Metabolic Alkalosis

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