Abstract
This case is a 42-year-old female with a chief complaint of pain in the right knee joint. Hyperuricemia and elevated carcinoembryonic antigen level were pointed out at a local hospital and the patient was referred to us. The patient had hypotension, hypopotassemia and elevated plasma renin activity. Barium enema showed an elevated lesion in the ascending colon. CT disclosed low density areas in the liver and calcification of both renal medullae. Right hemicolectomy, hepatectomy and biopsy of the right kidney were perfomed. The tumor of the colon was adenocarcinoma. The liver showed a similar histological picture and a diagnosis of metastasis of colon cancer to the liver was made. In the kidney, hyperplasia and hypergranulation of the juxtaglomerular cells and sclerosis of almost half glomeruli were found. This patient had experienced repeated episodes of vomiting and taken diuretics and laxatives over a long term. Anorexia nervosa was also considered. This case was considered to be pseudo-Bartter syndrome due to these predisposing causes. This case, together with 67 cases reported previously in Japan, is described here with same discussion.
