Bartter's syndrome belongs to a group of hypokalemic renal channel diseases. 
These channels are located in the lipid layer of cell membranes where they exist 
as water channels through which ion transport is performed. Based on the type of 
genetic disorder and clinical presentation, Bartter's syndrome is classified as 
neonatal, classical and Gitelman's syndrome. Most of the cases have been noted 
in pediatric age groups and adult-onset cases are very rare. Moreover, an 
association between Bartter's syndrome and empty sella has recently been 
reported in 3 children. We report here the second case of an adult patient 
affected by Bartter's syndrome with partial empty sella. The patient showed some 
clinical and histological characteristics of both classic Bartter's syndrome and 
Gitelman's syndrome, suggesting that genotype and phenotype of Bartter's 
syndrome are not so clear-cut and that phenotypic overlap may occur, according 
to a recent hypothesis. Magnetic resonance imaging disclosed a partial empty 
sella. A thorough endocrinological investigation showed normal hypophyseal, 
thyroidal, adrenal and gonadal function. Good therapeutic effects were achieved 
using spironolactone, ACE-inhibitor and potassium supplementation, with 
normalization of the kalemia. At present, the value of the association of 
Bartter's syndrome and empty sella remains unclear and future studies are needed 
to clarify the importance of this association, both in children and in adult 
patients affected by Bartter's syndrome.