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Bartter's Syndrome: Renal Scintigraphic Appearance after Captopril Administration

Nuclear Medicine Service, S. Orsola-Malpighi Policlinic Hospital, Bologna, Italy

Correspondence: For correspondence contact: Stefano Fanti, MD, Nuclear Medicine Department, S. Orsola-Malpighi Hospital, Via Albertoni 15, 40138 Bologna, Italy. Reprints are not available from the authors.

ABSTRACT

We report a case of Bartter's syndrome, a rare disease characterized by hypokalemia, increased plasma renin and angiotensin II levels with normal blood pressure. During the diagnostic work-up, the patient had renal scintigraphy in baseline and after captopril administration. Pharmacological blockade of the renin-angiotensin system with captopril resulted in bilateral and symmetrical renal abnormalities (increase of parenchymal transit time, time to maximum activity and retained cortical activity, with cortical trapping of the radiopharmaceutical). Baseline scintigraphy was normal. The findings are consistent with Bartter's syndrome pathogenesis. Captopril renography may be useful to differentiate Bartter's syndrome from other covert causes of hypokalemia.

Key Words: Bartter's syndrome • renal scintigraphy • technetium-99m-MAG3