{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:40:06Z","timestamp":1756359606243,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,1,21]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>Bartter syndrome (BS) is a rare genetic tubulopathy affecting the loop of Henle leading to salt wasting. It is commonly seen in utero or in the early neonatal period. Rare cases of acquired BS are reported in association with infections like tuberculosis, granulomatous conditions like sarcoidosis, autoimmune diseases and drugs. The mainstay of management includes potassium, calcium and magnesium supplementation. We report the case of a woman in her 50s with a history of type 2 diabetes mellitus for the last 10 years, who presented with diabetic foot ulcers and generalised weakness with ECG changes suggestive of hypokalaemia. She had severe hypokalaemia with high urine potassium excretion and hypochloraemic metabolic alkalosis. She poorly responded to intravenously administered potassium supplements and had persistent hypokalaemia. On further evaluation of the persistent hypokalaemia, a diagnosis of idiopathic Bartter-like phenotype was made. She responded well to tablet indomethacin and is presently asymptomatic and is being maintained on tablet indomethacin after 6 months of follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2023-257953","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T12:25:26Z","timestamp":1707827126000},"page":"e257953","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Bartter syndrome-like phenotype in a patient with type 2 diabetes mellitus"],"prefix":"10.1136","volume":"17","author":[{"given":"Ravi","family":"Kumar","sequence":"first","affiliation":[{"name":"Internal Medicine, Armed Forces Medical College, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirmal","family":"Shreshta","sequence":"additional","affiliation":[{"name":"Internal Medicine, Armed Forces Medical College, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Samdarshi","sequence":"additional","affiliation":[{"name":"Internal Medicine, Armed Forces Medical College, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2079-128X","authenticated-orcid":false,"given":"Parikshit","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Internal Medicine, Armed Forces Medical College, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"2025082722104573000_17.2.e257953.1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(62)90214-0"},{"key":"2025082722104573000_17.2.e257953.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.10.035"},{"key":"2025082722104573000_17.2.e257953.3","unstructured":"Longo DL , Fauci AS , Kasper DL , et al . Principles of Internal Medicine. 18th ed. USA: The McGraw Hill Companies, 2012: 2360\u20131."},{"key":"2025082722104573000_17.2.e257953.4","first-page":"78","article-title":"Acquired bartter-like phenotype","volume":"63","author":"Gadwalkar","year":"2015","journal-title":"J Assoc Physicians India"},{"key":"2025082722104573000_17.2.e257953.5","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2147\/IJNRD.S155397","article-title":"Bartter syndrome: causes, diagnosis, and treatment","volume":"11","author":"Cunha","year":"2018","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"2025082722104573000_17.2.e257953.6","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V1181449"},{"key":"2025082722104573000_17.2.e257953.7","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1038\/gim.2015.56","article-title":"Differential diagnosis of bartter syndrome, gitelman syndrome, and pseudo-bartter\/gitelman syndrome based on clinical characteristics","volume":"18","author":"Matsunoshita","year":"2016","journal-title":"Genet Med"},{"key":"2025082722104573000_17.2.e257953.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032843"},{"key":"2025082722104573000_17.2.e257953.9","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.kint.2017.10.016","article-title":"Simultaneous sequencing of 37 genes identified causative mutations in the majority of children with renal tubulopathies","volume":"93","author":"Ashton","year":"2018","journal-title":"Kidney Int"},{"key":"2025082722104573000_17.2.e257953.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.08.027"},{"key":"2025082722104573000_17.2.e257953.11","first-page":"332","article-title":"Bartter syndrome with pulmonary Tuberculosis a shortly outlook","volume":"2","author":"Stoian","year":"2007","journal-title":"Med J Clin Med"},{"key":"2025082722104573000_17.2.e257953.12","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4103\/1319-2442.106314","article-title":"A novel case of persistent bartters-like syndrome associated with gentamicin exposure","volume":"24","author":"Workeneh","year":"2013","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"2025082722104573000_17.2.e257953.13","doi-asserted-by":"crossref","first-page":"208","DOI":"10.4103\/0022-3859.57407","article-title":"Amikacin-induced type 5 bartter-like syndrome with severe hypocalcemia","volume":"55","author":"Chrispal","year":"2009","journal-title":"J Postgrad Med"},{"key":"2025082722104573000_17.2.e257953.14","doi-asserted-by":"crossref","first-page":"411","DOI":"10.3109\/0886022X.2012.761084","article-title":"Acquired bartter-like syndrome associated with colistin use in a preterm infant","volume":"35","author":"Cakir","year":"2013","journal-title":"Ren Fail"},{"key":"2025082722104573000_17.2.e257953.15","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.37.174"},{"key":"2025082722104573000_17.2.e257953.16","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn600"},{"key":"2025082722104573000_17.2.e257953.17","first-page":"190","article-title":"Granulomatous sarcoid nephritis: a cause of multiple renal tubular abnormalities","volume":"14","author":"Muther","year":"1980","journal-title":"Clin Nephrol"},{"key":"2025082722104573000_17.2.e257953.18","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1186\/s13256-018-1752-6","article-title":"Bartter syndrome-like phenotype in a patient with diabetes: a case report","volume":"12","author":"Dalugama","year":"2018","journal-title":"J Med Case Reports"},{"key":"2025082722104573000_17.2.e257953.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1990.tb00273.x"},{"key":"2025082722104573000_17.2.e257953.20","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S1726-4901(09)70029-2","article-title":"Bartter\u2019s syndrome with type 2 diabetes mellitus","volume":"72","author":"See","year":"2009","journal-title":"J Chin Med Assoc"},{"key":"2025082722104573000_17.2.e257953.21","unstructured":"Feehally J . Comprehensive clinical nephrology. Sixth edition. Elsevier, 2019: 580\u20131."},{"key":"2025082722104573000_17.2.e257953.22","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.4172\/2161-1017.1000201","article-title":"Late onset Bartter syndrome in type 2 diabetes mellitus scarcely compensated: A case report study","volume":"04","author":"Gniuli","year":"2015","journal-title":"Endocrinol Metab Syndr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-257953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:10:56Z","timestamp":1756357856000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-257953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,13]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/bcr-2023-257953"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-257953","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}