Otsubo Yuto, Kano Yuji, Suzumura Hiroshi, Yoshihara Shigemi
Department of Pediatrics, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
Department of Pediatrics, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.
BMJ Case Rep. 2021 Apr 7;14(4):e242086. doi: 10.1136/bcr-2021-242086.
Bartter syndrome (BS) is a well-recognised inherited tubular dysfunction that causes polyuria, metabolic alkalosis and hypokalaemia. Among BS cases, antenatal/neonatal BS (ABS) usually shows distinct polyhydramnios prenatally and presents features of BS in the early neonatal period. We encountered a premature infant with type 3 ABS presenting with mild polyuria and discuss the pathogenesis of mild polyuria in type 3 ABS. A male infant was born at 31 weeks' gestation. His mother received amniocentesis because of polyhydramnios. Hyponatraemia and hypokalaemia appeared within 3 days after birth. Metabolic alkalosis, hyperreninaemia and hyperaldosteronism were also identified. Temporary polyuria developed at 1 month after birth; however, the mean urine output during hospitalisation was within the normal range. compound heterozygous mutations were confirmed. Polyuria of type 3 ABS may be less severe than in other types of ABS. Lower urine sodium loss may be a characteristic feature of type 3 ABS.
巴特综合征(BS)是一种公认的遗传性肾小管功能障碍,可导致多尿、代谢性碱中毒和低钾血症。在巴特综合征病例中,产前/新生儿期巴特综合征(ABS)通常在产前表现出明显的羊水过多,并在新生儿早期呈现巴特综合征的特征。我们遇到了一名患有3型ABS的早产儿,表现为轻度多尿,并探讨了3型ABS中轻度多尿的发病机制。一名男婴在妊娠31周时出生。由于羊水过多,他的母亲接受了羊水穿刺检查。出生后3天内出现低钠血症和低钾血症。还发现了代谢性碱中毒、高肾素血症和高醛固酮血症。出生后1个月出现暂时性多尿;然而,住院期间的平均尿量在正常范围内。确认存在复合杂合突变。3型ABS的多尿可能不如其他类型的ABS严重。较低的尿钠丢失可能是3型ABS的一个特征。