Polymyxin B-induced Bartter syndrome.

Bhavesh Mohan Lal, Nimisha Musthafa Hafeesa, Naval Kishore Vikram, Animesh Ray

BMJ case reports 2024 May 03

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Bartter syndrome is a genetic disorder characterised by chloride-unresponsive metabolic alkalosis, hypokalaemia, hypomagnesaemia and hypercalciuria. While it commonly presents antenatally or in early infancy, sometimes, drugs can induce a state similar to Bartter syndrome in any age group, called acquired Bartter syndrome. Polymyxins and aminoglycosides are the most commonly implicated drugs. Polymyxin B and polymyxin E (popularly known as colistin) are the two chemically similar polymyxins that are commonly used clinically. While colistin is frequently associated with nephrotoxicity, polymyxin B is generally considered less nephrotoxic. This difference is due to the way these two drugs are handled by the kidneys. In this case report, we discuss a middle-aged male who developed Bartter syndrome due to polymyxin B, which resolved on discontinuation of the drug, and re-appeared after its re-introduction later. This case exemplifies the nephrotoxicity caused by polymyxin B and the need for vigilance when using this drug. © BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Bhavesh Mohan Lal, Nimisha Musthafa Hafeesa, Naval Kishore Vikram, Animesh Ray. Polymyxin B-induced Bartter syndrome. BMJ case reports. 2024 May 03;17(5)