Document Detail


Autosomal dominant hypocalcemia with mild type 5 Bartter syndrome.
MedLine Citation:
PMID:  17048213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Type 5 Bartter syndrome has been recently defined as a Bartter syndrome due to the most activating mutations of the calcium-sensing receptor (CaSR). It has been attributed to the inhibition exerted by CaSR activity on sodium transport in the thick ascending limb of the loop of Henle (TALH). Two monozygotic twin sisters (T1 and T2) with autosomal dominant hypocalcemia (ADH) due to a nonconservative activating CaSR mutation in the extracellular domain (K29E) were studied. They developed a Bartter-like syndrome characterized by a mild phenotype: hypokalemia occurred only at the age of 22 years; it was corrected with small doses of oral potassium in one twin, while the other twin needed no potassium supplements to maintain borderline levels of plasma potassium; alkalosis was absent; plasma renin and aldosterone production were not markedly activated. Furthermore, the natriuretic response to furosemide, a inhibitor of sodium reabsorption in the TALH, was conserved in both twins. The K29E mutation was previously reported as one of the most activating mutations of the CaSR gene leading to a very marked increase in CaSR sensitivity to calcium ions. These findings confirm that Bartter syndrome is typically associated with ADH provided that the underlying mutation of CaSR is able to produce a conspicuous gain of function. However, the phenotype of type 5 Bartter syndrome may manifest with variable severity, not directly related with the in vitro potency of the CaSR activating mutation.
Authors:
Giuseppe Vezzoli; Teresa Arcidiacono; Vera Paloschi; Annalisa Terranegra; Rita Biasion; Giovanna Weber; Stefano Mora; Marie Louise Syren; Domenico Coviello; Daniele Cusi; Giuseppe Bianchi; Laura Soldati
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of nephrology     Volume:  19     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-10-18     Completed Date:  2006-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  525-8     Citation Subset:  IM    
Affiliation:
Nephrology and Dialysis Unit, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy. vezzoli.giuseppe@hsr.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Bartter Syndrome / genetics*
Diseases in Twins*
Female
Humans
Hypocalcemia / etiology,  genetics*
Mutation*
Receptors, Calcium-Sensing / genetics*,  physiology
Chemical
Reg. No./Substance:
0/CASR protein, human; 0/Receptors, Calcium-Sensing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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