Indomethacin and Atrial Natriuretic Peptide in Pseudo-Bartter's Syndrome

Abstract
To the Editor: Gordon et al.1 (Aug. 14 issue) reported the effects of indomethacin on excessive secretion of plasma atrial natriuretic peptide (ANP) in Bartter's syndrome. We measured plasma ANP concentrations in a 27-year-old woman with pseudo-Bartter's syndrome due to furosemide abuse and a 38-year-old man with "true" Bartter's syndrome, in the control state and during treatment with indomethacin.The woman had various symptoms of Bartter's syndrome, including hypokalemic hypochloremic alkalosis (potassium, 2.2 mmol per liter; chloride, 81 mmol per liter; pH 7.54), hyperactivity of the renin–angiotensin–aldosterone system (plasma renin activity, 24 ng per milliliter per hour [normal, 0.3 to . . .