Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jul;25(7):822-824.
doi: 10.5005/jp-journals-10071-23898.

Acquired Bartter-like Syndrome Presenting with Polyuria and Reversible Hypokalemia Associated with Colistin Use in a Critically Ill Pediatric Patient

Damla P Yavas  1 , Faruk Ekinci  1 , Ozden O Horoz  1 , Ozlem O Gundeslioglu  2 , Bahriye Atmis  3 , Dincer Yildizdas  1
Affiliations
Case Reports

Acquired Bartter-like Syndrome Presenting with Polyuria and Reversible Hypokalemia Associated with Colistin Use in a Critically Ill Pediatric Patient

Damla P Yavas et al. Indian J Crit Care Med. 2021 Jul.

Abstract

We report a case of an acquired Bartter-like syndrome (BLS) after 3 days of treatment initiation and improved after discontinuation of colistin therapy in pediatric intensive care unit. A 2-month-old girl with spinal muscular atrophy type 1 who had respiratory distress received colistin therapy with a dose of 5 mg/kg/day for Acinetobacter baumannii complex isolation from endotracheal aspirate on the 12th day follow-up. Polyuria (6 mL/kg/hour) in the presence of normal blood pressure and hypokalemic metabolic alkalosis were developed on the 3rd day of colistin treatment. Colistin was stopped on the 4th day, and 2 days after discontinuation of colistin, polyuria improved dramatically. Her metabolic alkalosis and hypokalemia discontinued after 2 and 4 days, respectively. There are very few reports about colistin-induced BLS. The onset of polyuria, hypokalemia, and metabolic alkalosis during treatment with colistin and resolution after interruption suggest a causative relationship. How to cite this article: Yavas DP, Ekinci F, Horoz OO, Gundeslioglu OO, Atmis B, Yildizdas D. Acquired Bartter-like Syndrome Presenting with Polyuria and Reversible Hypokalemia Associated with Colistin Use in a Critically Ill Pediatric Patient. Indian J Crit Care Med 2021;25(7):822-824.

Keywords: Bartter-like syndrome; Colistin; Hypokalemia; Pediatric; Polyuria.

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
Graphical representation of serum potassium, serum bicarbonate, and 24-hour urinary output trend. Day 12: Colistin started; Day 15: Colistin stopped
See this image and copyright information in PMC

References

    1. Li J, Nation RI, Turnidge JD, Milne RW, Coulthard K, Rayner CR, et al. Colistin: the re-emerging antibiotic for multidrug-resistant Gram negative bacterial infections. Lancet Infect Dis. 2006;6(9):589–601. doi: 10.1016/S1473-3099(06)70580-1. DOI: - DOI - PubMed
    1. Tabish M, Mahendran M, Ray A, Vikram NK. Colistin-induced acquiredBartter-like syndrome: an unusual cause of meltdown. BMJ Case Rep. 2020;13:e232630. doi: 10.1136/bcr-2019-232630. DOI: - DOI - PMC - PubMed
    1. Poirel L, Jayol A, Nordmann P. Polymyxins: antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes. Clin Microbiol Rev. 2017;30(2):557–596. doi: 10.1128/CMR.00064-16. DOI: - DOI - PMC - PubMed
    1. Javan AO, Shokouhi S, Sahraei Z. A review on colistin nephrotoxicity. Eur J Clin Pharmacol. 2015;71(7):801–810. doi: 10.1007/s00228-015-1865-4. DOI: - DOI - PubMed
    1. Cakir U, Alan S, Zeybek C, Erdeve O, Atasay B, Yalcinkaya F, et al. Acquired bartter-like syndrome associated with colistin use in a preterm infant. Ren Fail. 2013;35(3):411–413. doi: 10.3109/0886022X.2012.761084. DOI: - DOI - PubMed

Publication types

LinkOut - more resources