An Angiotensin Receptor Blocker and Spironolactone Enabled A Withdrawal from Furosemide and KCl in A Patient with Pseudo-Bartter's Syndrome

Naoto ASHIZAWA; Satoki FUKAE; Kyoei TANAKA; Nobuaki SUZUKI; Shinji SETO; Katsusuke YANO

doi:10.11343/amn.49.107

CASE REPORT

An Angiotensin Receptor Blocker and Spironolactone Enabled A Withdrawal from Furosemide and KCl in A Patient with Pseudo-Bartter's Syndrome

Naoto ASHIZAWA, Satoki FUKAE, Kyoei TANAKA, Nobuaki SUZUKI, Shinji SETO, Katsusuke YANO

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Keywords: Aldosterone breakthrough, Angiotensin receptor blocker, Furosemide, Pseudo-Bartter's syndrome, Total body potassium

JOURNAL FREE ACCESS

2004 Volume 49 Issue 3 Pages 107-109

DOI https://doi.org/10.11343/amn.49.107

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Abstract

A 30-year-old woman with pseudo-Bartter's syndrome was referred to our department because of hypokalemic symptoms caused by outrageous abuse of furosemide and by KCl infusion administered to compensate for it. As an attempt to break this vicious cycle, we first tried to change furosemide with azosemide, a long-lasting loop diuretics, to avoid acute excessive diuresis and excretion of potassium. Administration of losartan effectively attenuated the concentration of extremely activated plasma aldosterone. Administration of spironolactone reduced aldosterone breakthrough induced by losartan and the patient was released from both furosemide and KCl. Blocking renin-angiotensin-aldosterone system demonstrated to be an effective treatment for pseudo-Bartter's syndrome by the improvement of the total body potassium level which was decreased before treatment.

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