A patient with cystinosis presenting transient features of Bartter syndrome

A 16-month-old boy was admitted to the clinic because of vomiting and growth failure. His weight and height measurements were under the fifth percentile. He had fair hair and skin, enlarged wrists and rachitic rosaries. The presence of metabolic alkalosis, hypokalemia, hypochloremia, and high...

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Main Authors: Bilal Yildiz, Sultan Durmuş-Aydoğdu, Nurdan Kural, Kismet Bildirici, Hikmet Başmak, Coşkun Yarar
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2006-07-01
Series:The Turkish Journal of Pediatrics
Online Access:https://turkjpediatr.org/article/view/2641
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author Bilal Yildiz
Sultan Durmuş-Aydoğdu
Nurdan Kural
Kismet Bildirici
Hikmet Başmak
Coşkun Yarar
author_facet Bilal Yildiz
Sultan Durmuş-Aydoğdu
Nurdan Kural
Kismet Bildirici
Hikmet Başmak
Coşkun Yarar
author_sort Bilal Yildiz
collection DOAJ
description A 16-month-old boy was admitted to the clinic because of vomiting and growth failure. His weight and height measurements were under the fifth percentile. He had fair hair and skin, enlarged wrists and rachitic rosaries. The presence of metabolic alkalosis, hypokalemia, hypochloremia, and high renin and aldosterone levels were suggestive of Bartter syndrome. However, in view of the growth failure, fair hair and skin, proteinuria, polyuria and active rickets, cystinosis was considered. Bone marrow smear examination was normal, despite the existence of suspicious crystals in the cornea. Cystine crystals were seen in the conjunctiva biopsy and increased leukocyte cystine level was measured; therefore, definitive cystinosis diagnosis was made. Renal Fanconi syndrome with metabolic acidosis is prominent in cystinosis; however, in rare instances, if sodium-dependent trans-tubular transport defect is present, patients could have Bartter syndrome findings such as hypochloremic metabolic alkalosis. Our case is a good example demonstrating that metabolic alkalosis should not exclude cystinosis and the other signs and symptoms of the patient should be thoroughly evaluated.
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publishDate 2006-07-01
publisher Hacettepe University Institute of Child Health
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series The Turkish Journal of Pediatrics
spelling doaj-art-03be8c8c927642f19163d09cbb19081d2025-08-20T03:16:23ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212006-07-01483A patient with cystinosis presenting transient features of Bartter syndromeBilal Yildiz0Sultan Durmuş-AydoğduNurdan KuralKismet BildiriciHikmet BaşmakCoşkun YararDepartment of Pediatrics, Osmangazi University Faculty of Medicine, Eskişehir, Turkey. A 16-month-old boy was admitted to the clinic because of vomiting and growth failure. His weight and height measurements were under the fifth percentile. He had fair hair and skin, enlarged wrists and rachitic rosaries. The presence of metabolic alkalosis, hypokalemia, hypochloremia, and high renin and aldosterone levels were suggestive of Bartter syndrome. However, in view of the growth failure, fair hair and skin, proteinuria, polyuria and active rickets, cystinosis was considered. Bone marrow smear examination was normal, despite the existence of suspicious crystals in the cornea. Cystine crystals were seen in the conjunctiva biopsy and increased leukocyte cystine level was measured; therefore, definitive cystinosis diagnosis was made. Renal Fanconi syndrome with metabolic acidosis is prominent in cystinosis; however, in rare instances, if sodium-dependent trans-tubular transport defect is present, patients could have Bartter syndrome findings such as hypochloremic metabolic alkalosis. Our case is a good example demonstrating that metabolic alkalosis should not exclude cystinosis and the other signs and symptoms of the patient should be thoroughly evaluated. https://turkjpediatr.org/article/view/2641
spellingShingle Bilal Yildiz
Sultan Durmuş-Aydoğdu
Nurdan Kural
Kismet Bildirici
Hikmet Başmak
Coşkun Yarar
A patient with cystinosis presenting transient features of Bartter syndrome
The Turkish Journal of Pediatrics
title A patient with cystinosis presenting transient features of Bartter syndrome
title_full A patient with cystinosis presenting transient features of Bartter syndrome
title_fullStr A patient with cystinosis presenting transient features of Bartter syndrome
title_full_unstemmed A patient with cystinosis presenting transient features of Bartter syndrome
title_short A patient with cystinosis presenting transient features of Bartter syndrome
title_sort patient with cystinosis presenting transient features of bartter syndrome
url https://turkjpediatr.org/article/view/2641
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