A 59-year-old female patient with rheumatoid arthritis showed hypokalemic metabolic alkalosis, normotensive hyperreninemic hyperaldosteronism and high urinary prostaglandin level. She was thought to have Bartter's syndrome. But, her kidney biopsy specimen showed chronic interstitial nephritis. She have used acetaminophen containing analgesics for recent three years. So we thought her disease was caused by drug. But, in this case, clinical manifestations are correspond with Bartter's syndrome and we have witnessed a successful respond to kalium replacement, angiotensin converting enzyme inhibitor, prostaglandin inhibitor and spironolactone administration.
Acetaminophen ; Alkalosis ; Analgesics ; Arthritis, Rheumatoid* ; Bartter Syndrome ; Biopsy ; Female ; Glycogen Storage Disease Type VI ; Humans ; Hyperaldosteronism ; Kidney ; Middle Aged ; Nephritis, Interstitial* ; Peptidyl-Dipeptidase A ; Prostaglandin Antagonists ; Spironolactone