Characteristic Changes of the Juxtaglomerular Cells before and after Treatment of Pseudo-Bartter’s Syndrome due to Furosemide Abuse

Mizuiri, Sonoo; Ozawa, Takashi; Hirata, Kiyofumi; Takezawa, Kimiko; Kawamura, Sadao

doi:10.1159/000184290

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Concerning diuretic abuse, tubulointerstitital nephritis (swelling of the kidney tubules) has been associated with abuse of the diuretic furosemide . Furosemide abuse is thought to cause changes in the granules of juxtaglomerular cells (cells that produce the enzyme renin) in the kidneys; these changes begin to reverse with the cessation of furosemide use . Finally, renal failure has been attributed to diuretic and laxative use, both in individuals with eating disorders and those without eating disorders .…”

Section: Laxative and Diuretic Abusementioning

confidence: 99%

“…96 Furosemide abuse is thought to cause changes in the granules of juxtaglomerular cells (cells that produce the enzyme renin) in the kidneys; these changes begin to reverse with the cessation of furosemide use. 97 Finally, renal failure has been attributed to diuretic and laxative use, both in individuals with eating disorders 98,99 and those without eating disorders. [100][101][102] Renal failure is likely mediated by hypokalemia (low potassium in the blood) in these cases.…”

Section: Kidneymentioning

confidence: 99%

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The medical complications associated with purging

Forney

Buchman‐Schmitt

Keel

et al. 2016

Intl J Eating Disorders

108

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Objective Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors. Method Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers involved case studies or small, uncontrolled samples. Given the limited evidence base, we conducted a qualitative (rather than systematic) review to identify medical complications that have been attributed to purging behaviors. Results Medical conditions affecting the teeth, esophagus, gastrointestinal system, kidneys, skin, cardiovascular system, and musculoskeletal system were identified, with self-induced vomiting causing the most medical complications. Conclusions Purging behavior can be associated with severe medical complications across all body systems. Mental health professionals should refer patients with purging behaviors to medical providers for screening and treatment as needed. The medical work-up for individuals with eating disorders should include a comprehensive metabolic panel, complete blood count, and a full body exam including the teeth to prevent severe complications. Medical providers should screen patients for purging behaviors and associated medical complications, even in the absence of an eating disorder diagnosis, to increase the detection of eating disorders. Recognizing the link between purging and medical complications can aid in identifying potential eating disorders, particularly those that often elude detection such as purging disorder.

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Section: Laxative and Diuretic Abusementioning

confidence: 99%

Section: Kidneymentioning

confidence: 99%

The medical complications associated with purging

Forney

Buchman‐Schmitt

Keel

et al. 2016

Intl J Eating Disorders

108

View full text Add to dashboard Cite

show abstract

A case of pseudo‐Bartter's syndrome due to intestinal malrotation

Koshida

Sakazume

Maruyama

et al. 1994

Pediatrics International

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Intestinal malrotation presenting beyond the neonatal period is associated with a multiplicity of symptoms, which are often non‐specific and, consequently, are associated with delays in diagnosis. Pseudo‐Bartter's syndrome, which mimics the manifestations of Bartter's syndrome, can be caused by a severe chloride deficiency secondary to vomiting, diarrhea, perspiration, diuretic abuse and so on. We describe a 6 year old boy who had been admitted to hospital three times during the preceding year. The patient lapsed into a critical condition with profound hypochloremia and hypokalemic metabolic alkalosis induced by extremely massive vomiting. The attacks of vomiting were spasmodic and self‐limited. During the episodes of vomiting he fulfilled the criteria of pseudo‐Bartter's syndrome, including hyperreninemia, hyperaldosteronism and normal blood pressure, but in the intervals between attacks he was completely asymptomatic. At the third admission, examination supported an overall clinical picture of bowel obstruction, which was confirmed by radiographic examination. Laparotomy revealed a midgut volvulus with intestinal malrotation. After surgery he made a good recovery and was symptom‐free. In this patient, the high degree of hypochloremia and hypovolemia activated the renin‐angiotensin‐aldosterone system, then aldosterone promoted intensive reabsorption of sodium and excretion of potassium into the urine. Consequently the diagnosis of pseudo‐Bartter's syndrome was established on the basis of an extreme decrease in urinary chloride and an increase in urinary potassium concentration. It is relatively rare for vomiting due to intestinal malrotation to induce pseudo‐Bartter's syndrome. The importance of considering this rare diagnosis in such cases is discussed.

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Characteristic Changes of the Juxtaglomerular Cells before and after Treatment of Pseudo-Bartter’s Syndrome due to Furosemide Abuse

Cited by 2 publications

References 8 publications

The medical complications associated with purging

The medical complications associated with purging

A case of pseudo‐Bartter's syndrome due to intestinal malrotation

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