Differential diagnosis of perinatal Bartter, Bartter and Gitelman syndromes
Autor: | Youssef Ahmed, Oluwatoyin Bamgbola |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Pediatrics
medicine.medical_specialty Transplantation Errata hypochloremic metabolic alkalosis business.industry pseudo-Bartter syndromes 030232 urology & nephrology Hypochloremic metabolic alkalosis 030204 cardiovascular system & hematology Gitelman syndrome medicine.disease Gitelman 03 medical and health sciences Bartter's syndrome 0302 clinical medicine Nephrology Medicine Differential diagnosis business AcademicSubjects/MED00340 Perinatal period acquired Bartter CKJ Reviews antenatal Bartter |
Zdroj: | Clinical Kidney Journal |
ISSN: | 2048-8513 2048-8505 |
Popis: | The common finding of hypokalemic alkalosis in several unrelated disorders may confound the early diagnosis of salt-losing tubulopathy (SLT). Antenatal Bartter syndrome (BS) must be considered in idiopathic early-onset polyhydramnios. Fetal megabladder in BS may allow its distinction from third-trimester polyhydramnios that occurs in congenital chloride diarrhea (CCD). Fetal megacolon occurs in CCD while fecal chloride >90 mEq/L in infants is diagnostic. Failure-to-thrive, polydipsia and polyuria in early childhood are the hallmarks of classic BS. Unlike BS, there is low urinary chloride in hypokalemic alkalosis of intractable emesis and cystic fibrosis. Rarely, renal salt wasting may result from cystinosis, Dent disease, disorders of paracellular claudin-10b and Kir4.1 potassium-channel deficiency. Acquired BS may result from calcimimetic up-regulation of a calcium-sensing receptor or autoantibody inactivation of sodium chloride co-transporters in Sjögren syndrome. A relatively common event of heterozygous gene mutations for Gitelman syndrome increases the likelihood of its random occurrence in certain diseases of adult onset. Finally, diuretic abuse is the most common differential diagnosis of SLT. Unlike the persistent elevation in BS, urinary chloride concentration losses waxes and wanes on day-to-day assessment in patients with diuretic misuse. |
Databáze: | OpenAIRE |
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