Hypochloremic metabolic alkalosis and failure to thrive: question

Excerpt

The patient was born at 36 weeks of gestation with a birth weight of 2,850 g as the first living male child of consanguineous apparently healthy parents from Libya. The pregnancy had been complicated by polyhydramnios. The mother reported two previous pregnancies, one resulting in early abortion, and the other in an anencephalic neonate. After birth, the patient showed prolonged jaundice, vomiting, and dehydration with hypokalemia, and the clinical diagnosis of neonatal Bartter syndrome was made. Initial treatment included intravenous fluids to correct hypovolemia and oral potassium solutions. The further clinical course was characterized by persistent diarrhea (8–9/day stools daily) complicated by frequent episodes of dehydration and water-electrolyte-imbalances leading to repeated hospitalizations. Because of the unremitting course and progressive failure to thrive, it was decided to refer the patient to our institution for further diagnosis and therapy. …