Home Medicine Late onset Bartter syndrome: Bartter syndrome type 2 presenting with isolated nephrocalcinosis and high parathyroid hormone levels mimicking primary hyperparathyroidism
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Late onset Bartter syndrome: Bartter syndrome type 2 presenting with isolated nephrocalcinosis and high parathyroid hormone levels mimicking primary hyperparathyroidism

  • Gizem Yıldız ORCID logo EMAIL logo , Meral Torun Bayram ORCID logo , Tayfun Çinleti ORCID logo , Altuğ Koç ORCID logo , Alper Soylu ORCID logo and Salih Kavukçu ORCID logo
Published/Copyright: August 12, 2022

Abstract

Objectives

Nephrocalcinosis is associated with conditions that cause hypercalcemia and the increased urinary excretion of calcium, phosphate, and/or oxalate. A monogenic etiology is found in almost 30% of childhood-onset nephrocalcinosis which is also a common manifestation of primary hyperparathyroidism. We discuss a child with nephrocalcinosis and features mimicking primary hyperparathyroidism.

Case presentation

A 7-year-old girl presented with nephrocalcinosis. Hypercalciuria, hyperphosphaturia, mild hypercalcemia, hypophosphatemia and elevated parathyroid hormone levels along with normal serum creatinine and absence of hypokalemic alkalosis suggested primary hyperparathyroidism. However, she was ultimately diagnosed with Bartter syndrome type 2 based on the presence of homozygous pathogenic variation in KCNJ1gene.

Conclusions

This is the second reported case of late-onset Bartter syndrome type 2 without hypokalemic alkalosis. Patients with Bartter syndrome may present with high parathyroid hormone levels and hypercalcemia in addition to hypercalciuria. Thus, the present case suggests that the KCNJ1 gene should be included in genetic analysis even in older children with isolated nephrocalcinosis.


Corresponding author: Gizem Yıldız, MD, Department of Pediatric Nephrology, Dokuz Eylül University Medical Faculty, 35340 Balçova, İzmir, Turkey, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from the mother of the patient.

  5. Ethical approval: Not applicable.

References

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Received: 2022-03-24
Accepted: 2022-07-24
Published Online: 2022-08-12
Published in Print: 2022-10-26

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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