It is essential to differentiate pseudo-Bartter's syndrome from Bartter's syndrome because both are accompanied by hypokalemia and metabolic alkalosis. In this study, we encountered a newborn girl with marked hypokalemia and metabolic alkalosis who was born vaginally at 41 weeks' gestation to a mother with pseudo-Bartter's syndrome and associated eating disorder. Venous blood gas analysis for transient respiratory distress revealed hypokalemia. Because hypokalemia did not improve, the newborn was transferred to our hospital 3 days after birth. Hema tological findings on admission showed serum potassium 2.6 mEq/L, bicarbonate 36.3 mmol/L, and base excess 12.8 mmol/L, with pH 7.56 and metabolic alkalosis. Electrocardiography (ECG) revealed sinus bradycardia as well as ST-segment depression, T-wave flattening, and prominent U-waves in all chest leads. Administration of enteral potassium began on postnatal day 5 but was terminated on postnatal day 7 because of rapid elevation of serum potassium, with consequent reversion of ECG abnormalities to age-appropriate levels. We later learned that the mother's serum potassium level was around 2 mEq/L because of the eating disorder, which frequently caused vomiting. Our findings suggest that this was a case of neonatal pseudo-Bartter's syndrome accompanied by severe electrolyte abnormalities and ECG changes due to maternal pseudo-Bartter's syndrome.

Cryptosporidium is the most common protozoan that can infect a wide range of animals, including mammals and birds. Avian Cryptosporidium spp. can cause enteric and respiratory diseases which can be fatal in birds and some species are zoonotic. Companion birds have the potential as reservoir due to their close contact with humans. Pet shops are the major source of companion birds. However, few reports are available regarding Cryptosporidium spp. infection among companion birds kept in pet shops. The present study reports the prevalence and molecular characteristics of Cryptosporidium spp. among companion birds kept in pet shops in Japan. A total of 265 fresh fecal samples were obtained from birds kept in 4 pet shops; these birds belonged to 41 species in 3 bird orders. A nested polymerase chain reaction (PCR) assay targeting the small subunit rRNA gene was employed for the detection of Cryptosporidium spp. A total of 24 samples (9.1%) were positive, and Cryptosporidium spp. were detected from all pet shops. The prevalence of Cryptosporidium spp. in each of the bird orders was 6.5% (10/153) in Psittaciformes, 14.4% (13/90) in Passeriformes, and 4.5% (1/22) in Galliformes. Based on sequence analysis, 13 (54.2%) isolates were classified to C. galli, 8 (33.3%) were avian genotype III, and the remaining 3 (12.5%) were C. baileyi. No infection with zoonotic C. meleagridis and no coinfection with multiple Cryptosporidium spp. and/or genotypes were observed. The zoonotic potential of Cryptosporidium spp. infecting companion birds kept in pet shops in Japan is likely to be low.
Animals ; Birds ; Coinfection ; Cryptosporidium ; Friends ; Galliformes ; Genes, rRNA ; Genotype ; Humans ; Japan ; Mammals ; Passeriformes ; Polymerase Chain Reaction ; Pregnancy ; Prevalence ; Psittaciformes ; Sequence Analysis