Abstract
OBJECTIVE: Bartter's syndrome is a rare genetic disorder characterized by renal salt wasting, hypokalemia and metabolic alkalosis. CASE REPORT: A 32 years old male patient presented to casualty with complaints of generalised weakness and chest pain of 15 days duration. Patient had pallor, with loss of buccal pad of fat, skin turgor was lost, and extremities were cold. PR-90bpm, feeble, BP-50/40mmHg. History of similar complaints 1 month back for which he was hospitalised for 15 days and was not completely relieved of symptoms. The differential diagnosis of metabolic alkalosis with hypokalemia without hypertension are; 1. Bartter's syndrome, 2. Gitelman's syndrome, 3. Surreptitious vomiting and 4. Diuretic abuse. CONCLUSION: Acquired Bartter's and Gitelman's like syndromes have been described with autoimmune disorders, sarcoidosis and various drugs. This patient could have a yet undetected or unknown mutation of a protein which has a structural or a functional role in renal tubular cells (of Loop of Henle).
KEY WORDS: Bartter's syndrome; Renal salt wasting; Hypokalemia; Metabolic alkalosis; Sarcoidosis.