Colistin-induced acquired Bartter-like syndrome: an unusual cause of meltdown. Issue 2 (5th February 2020)

• Record Type: Journal Article
• Authors: Tabish, Mohammad; Mahendran, Manjit; Ray, Animesh; Vikram, Naval Kishore
• Is Part Of: BMJ case reports. Volume 13:Issue 2(2020)
• Publication Date: 2020-02-05
• Subjects: infections -- drugs: infectious diseases -- fluid electrolyte and acid-base disturbances; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-232630
• Languages: English
• ISSNs: 1757-790X

Abstract

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.