Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Dec;81(6):508–510. doi: 10.1136/adc.81.6.508

Dose related growth response to indometacin* in Gitelman syndrome

L Liaw 1, K Banerjee 1, M Coulthard 1
PMCID: PMC1718164  PMID: 10569969

Abstract

Growth failure is a recognised feature of Gitelman syndrome, although it is not as frequent as in Bartter syndrome. Indometacin is reported to improve growth in Bartter syndrome, but not in Gitelman syndrome, where magnesium supplements are recommended. This paper presents 3 sisters with Gitelman syndrome who could not tolerate magnesium supplements, and whose hypotension and polyuria were eliminated by taking 2 mg/kg/day indometacin, but who grew poorly. However, increasing the indometacin dose to 4 mg/kg/day improved their growth significantly, without changing their symptoms or biochemistry. Gastrointestinal haemorrhage necessitated the use of misoprostol.



Full Text

The Full Text of this article is available as a PDF (64.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bettinelli A., Basilico E., Metta M. G., Borella P., Jaeger P., Bianchetti M. G. Magnesium supplementation in Gitelman syndrome. Pediatr Nephrol. 1999 May;13(4):311–314. doi: 10.1007/s004670050615. [DOI] [PubMed] [Google Scholar]
  2. Bettinelli A., Bianchetti M. G., Girardin E., Caringella A., Cecconi M., Appiani A. C., Pavanello L., Gastaldi R., Isimbaldi C., Lama G. Use of calcium excretion values to distinguish two forms of primary renal tubular hypokalemic alkalosis: Bartter and Gitelman syndromes. J Pediatr. 1992 Jan;120(1):38–43. doi: 10.1016/s0022-3476(05)80594-3. [DOI] [PubMed] [Google Scholar]
  3. Bettinelli A., Metta M. G., Perini A., Basilico E., Santeramo C. Long-term follow-up of a patient with Gitelman's syndrome. Pediatr Nephrol. 1993 Feb;7(1):67–68. doi: 10.1007/BF00861573. [DOI] [PubMed] [Google Scholar]
  4. Dillon M. J., Ryness J. M. Plasma renin activity and aldosterone concentration in children. Br Med J. 1975 Nov 8;4(5992):316–319. doi: 10.1136/bmj.4.5992.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dillon M. J., Shah V., Mitchell M. D. Bartter's syndrome: 10 cases in childhood. Results of long-term indomethacin therapy. Q J Med. 1979 Jul;48(191):429–446. [PubMed] [Google Scholar]
  6. Ghazali S., Barratt T. M. Urinary excretion of calcium and magnesium in children. Arch Dis Child. 1974 Feb;49(2):97–101. doi: 10.1136/adc.49.2.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Graham D. Y., Agrawal N. M., Roth S. H. Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. Lancet. 1988 Dec 3;2(8623):1277–1280. doi: 10.1016/s0140-6736(88)92892-9. [DOI] [PubMed] [Google Scholar]
  8. Littlewood J. M., Lee M. R., Meadow S. R. Treatment of Bartter's syndrome in early childhood with prostaglandin synthetase inhibitors. Arch Dis Child. 1978 Jan;53(1):43–48. doi: 10.1136/adc.53.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mackie F. E., Hodson E. M., Roy L. P., Knight J. F. Neonatal Bartter syndrome--use of indomethacin in the newborn period and prevention of growth failure. Pediatr Nephrol. 1996 Dec;10(6):756–758. doi: 10.1007/s004670050210. [DOI] [PubMed] [Google Scholar]
  10. Pearce S. H. Straightening out the renal tubule: advances in the molecular basis of the inherited tubulopathies. QJM. 1998 Jan;91(1):5–12. doi: 10.1093/qjmed/91.1.5. [DOI] [PubMed] [Google Scholar]
  11. Proesmans W., Massa G., Vanderschueren-Lodeweyckx M. Growth from birth to adulthood in a patient with the neonatal form of Bartter syndrome. Pediatr Nephrol. 1988 Apr;2(2):205–209. doi: 10.1007/BF00862592. [DOI] [PubMed] [Google Scholar]
  12. Requeira O., Rao J., Baliga R. Response to growth hormone in a child with Bartter's syndrome. Pediatr Nephrol. 1991 Sep;5(5):671–672. doi: 10.1007/BF00856666. [DOI] [PubMed] [Google Scholar]
  13. Rodríguez-Soriano J. Bartter and related syndromes: the puzzle is almost solved. Pediatr Nephrol. 1998 May;12(4):315–327. doi: 10.1007/s004670050461. [DOI] [PubMed] [Google Scholar]
  14. Seidel C., Reinalter S., Seyberth H. W., Schärer K. Pre-pubertal growth in the hyperprostaglandin E syndrome. Pediatr Nephrol. 1995 Dec;9(6):723–728. doi: 10.1007/BF00868723. [DOI] [PubMed] [Google Scholar]
  15. Simon D. B., Karet F. E., Hamdan J. M., DiPietro A., Sanjad S. A., Lifton R. P. Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na-K-2Cl cotransporter NKCC2. Nat Genet. 1996 Jun;13(2):183–188. doi: 10.1038/ng0696-183. [DOI] [PubMed] [Google Scholar]
  16. Simon D. B., Nelson-Williams C., Bia M. J., Ellison D., Karet F. E., Molina A. M., Vaara I., Iwata F., Cushner H. M., Koolen M. Gitelman's variant of Bartter's syndrome, inherited hypokalaemic alkalosis, is caused by mutations in the thiazide-sensitive Na-Cl cotransporter. Nat Genet. 1996 Jan;12(1):24–30. doi: 10.1038/ng0196-24. [DOI] [PubMed] [Google Scholar]
  17. Taylor A. J., Dornan T. L. Successful treatment of short stature and delayed puberty in congenital magnesium-losing kidney. Ann Clin Biochem. 1993 Sep;30(Pt 5):494–498. doi: 10.1177/000456329303000517. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES