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Case of Bartter Syndrome Presenting With Hypokalemic Periodic Paralysis

Departments of Pediatric Neurology and Nephrology School of Medicine Akdeniz University Antalya, Turkey

Mustafa Koyun, MD

Departments of Pediatric Neurology and Nephrology School of Medicine Akdeniz University Antalya, Turkey

Sema Akman, MD

Departments of Pediatric Neurology and Nephrology School of Medicine Akdeniz University Antalya, Turkey

Ayfer Gür Güven, MD

Departments of Pediatric Neurology and Nephrology School of Medicine Akdeniz University Antalya, Turkey

enay Haspolat, MD

Departments of Pediatric Neurology and Nephrology School of Medicine Akdeniz University Antalya, Turkey, shaspolat{at}akdeniz.edu.tr

Hypokalemic periodic paralysis can occur secondarily to excessive potassium loss. Thyrotoxicosis, diuretic ingestions, hyperaldosteronism, barium poisoning, Gitelman syndrome, and Bartter syndrome are among the disorders causing secondary hypokalemic periodic paralysis. Clinical presentation of Bartter syndrome with hypokalemic periodic paralysis is rare. A 12-year-old boy was admitted to our hospital because of transient paralysis. He had been suffering from transient weakness attacks for 2 years and had had a total of 10 attacks, lasting 1 to 3 days. He had growth retardation, polyuria, and polydipsia. Laboratory examinations revealed hypokalemic alkalosis, normomagnesemia, hypercalciuria, and hyperaldosteronism. The clinical and laboratory findings were in accordance with Bartter syndrome. He has been followed up for 6 months and has suffered no further paralytic attacks under indomethacin therapy. This case highlights the importance of blood pH measurement in patients with hypokalemic periodic paralysis; it might prevent misdiagnosis and mismanagement in such diseases. (J Child Neurol 2006;21:255—256; DOI 10.2310/7010.2006.00049).

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