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Case Reports
. 2020 Feb 5;13(2):e232630.
doi: 10.1136/bcr-2019-232630.

Colistin-induced acquired Bartter-like syndrome: an unusual cause of meltdown

Mohammad Tabish  1 , Manjit Mahendran  1 , Animesh Ray  2 , Naval Kishore Vikram  1
Affiliations
Case Reports

Colistin-induced acquired Bartter-like syndrome: an unusual cause of meltdown

Mohammad Tabish et al. BMJ Case Rep. .

Abstract

Colistin-induced nephrotoxicity is commonly associated with elevation of serum creatinine level or a reduction of urine output. Uncommonly, tubulopathy associated with colistin has been reported. Here we present a unique case of a 46-year-old man who developed polyuria, hypokalaemia, hypocalcaemia, hypomagnesemia and metabolic alkalosis after 3 days of therapy with intravenous colistimethate sodium. After ruling out other causes, a diagnosis of colistin-induced acquired Bartter syndrome was made. The patient required daily aggressive intravenous repletion of fluids and electrolytes. However, polyuria and metabolic abnormalities abated only after drug discontinuation.

Keywords: drugs: infectious diseases; fluid electrolyte and acid-base disturbances; infections.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Graphical representation of electrolyte and 24-hour urinary output trend.
See this image and copyright information in PMC

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