Factitious Bartter's syndrome

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Abstract
A 29 yr old man had a 6 mo. history of fatigue and hypokalemia. Gastrointestinal K losses were not judged significant. The patients denied ingestion of licorice, large quantities of laxatives or diuretics. Clinical and laboratory findings were consistent with Bartter''s syndrome in the adult. Normal blood pressure, hypokalemic alkalosis and hyperaldosteronism, with insensitivity to the pressor effect of angiotensin infusion, were present. Juxtaglomerular hyperplasia was not demonstrated because thiazide was detected in the urine, utilizing chemical extraction and spectrophotometry. Surreptitious ingestion of diuretics must be excluded in any adult patient in whom a diagnosis of Bartter''s syndrome is considered.

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