Bartter-like Syndrome In a Patient Receiving Capreomycin For The Treatment Of Multidrug-Resistant Tuberculosis

Abstract

Bartter syndrome is inherited tubulopathy caused by mutations in several genes causing hypokalemia, hypomagnesemia, hypocalcemia with hypercalciuria, and metabolic alkalosis. Beside from inherited disorder, Bartter syndrome can be caused by the use of aminoglycosides, so it is called Bartter-like syndrome. Hypokalemia has been reported as a side effect of aminoglycosides in many studies, but Bartter-like syndrome due to aminoglycosides has only been reported in a few case reports. We report a 43 years old female patient who developed muscle weakness due to hypokalemia. We found the patient’s laboratory results was consistent with Bartter syndrome. The patient had MDR-TB and received combination therapy with capreomycin for two months. We diagnosed a patient with Bartter-like syndrome due to capreomycin. Following diagnosis, we discontinued capreomycin and started potassium, magnesium and calcium therapy. After electrolyte imbalances improved, capreomycin was given three times per week and the patient was no longer experiencing the same condition.

Acute flaccid paralysis in Indonesian adult due to suspected familial hypokalemia paralysis: A rare case

“…The deficit should be corrected gradually over 24–48 hours with regular monitoring of plasma K+ concentrations to avoid transient overrepletion and transient hyperkalemia [ 3 , 12 ]. Effective management of hypokalemic is used to reduce mortality in hypokalemic patients, of which 20% of hypokalemic patients die [ 13 ].…”

The role of C-Reactive protein as an inflammatory marker to predict prolonged QTc interval in rifampicin-resistant tuberculosis patients: A case-control study

“…Although patients with hypokalemia, hypocalcemia, and hypomagnesemia were not included in this study, it was known that potassium levels decreased in the continuation phase along with decreased calcium and magnesium. Aminy and Mardiana declare that hypokalemia is often associated with an imbalance of other electrolytes, such as hypomagnesemia and hypocalcemia in patients who received aminoglycoside drugs [ 29 ]. Treatment for RR-TB patients using a shorter regimen, including aminoglycosides in this study perhaps affected reduced K, Ca, and Mg in the continuation phase.…”

Bartter Syndrome: A Case Report

“…[9][10][11] On laboratory examination, the patient found alkalosis, and diarrhea. 16 Patients with high urine chloride levels (>20 mmol/L) and low or normal blood pressure can be due to diuretics, Gitelman's syndrome, and Bartter's syndrome. The most common cause of hypokalemia is the use of diuretic therapy, but it can be ruled out from history.…”

“…In this patient, the molar ratio of urine calcium and creatinine was 0.22, which indicated hypercalciuria. 15,16…”