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DOI: 10.1055/s-2008-1078705
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
A Case of Gitelman's Syndrome Presenting with Extreme Hypokalaemia and Paralysis
Publikationsverlauf
received 15.05.2007
first decision 02.10.2007
accepted 18.04.2008
Publikationsdatum:
03. Juni 2008 (online)

Abstract
Gitelman's syndrome is an autosomal recessive disorder caused by various mutations of the thiazide- sensitive sodium chloride cotransporter gene. Hypokalaemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria are major clinical features of the syndrome. The onset of the disease is in early adulthood with a mild muscle weakness complaint or incidentally diagnosed hypokalaemia by blood test. However, it has a significant impact on quality of life of patients. Rarely, patients with Gitelman's syndrome may present with hypokalaemic paralysis. Profound hypokalaemia is uncommon in Gitelman's syndrome. Here we report a case of Gitelman's syndrome, who presented with hypokalaemic paralysis and extreme hypokalaemia. To the best of our knowledge, after a Medline search, this is the most severe hypokalaemia described in a patient with Gitelman's syndrome.
Key words
potassium - muscle weakness - hypocalciuria - Gitelman's syndrome
References
- 1 Gitelman HJ, Graham JB, Welt LG. A new familial disorder characterized by hypokalemia and hypomagnesemia. Trans Assoc Am Physicians. 1966; 79 221-235
- 2 Kamel KS, Oh MS, Halperin ML. Bartter's, Gitelman's, and Gordon's syndromes. From physiology to molecular biology and back, yet still some unanswered questions. Nephron. 2002; 92 ((Suppl 1)) 18-27
- 3 Kamel KS, Harvey E, Douek K, Parmar MS, Halperin ML. Studies on the pathogenesis of hypokalemia in Gitelman's syndrome: role of bicarbonaturia and hypomagnesemia. Am J Nephrol. 1998; 18 ((1)) 42-49
- 4 Monnens L, Bindels R, Grunfeld JP. Gitelman syndrome comes of age. Nephrol Dial Transplant. 1998; 13 ((7)) 1617-1619
- 5 Cruz DN, Shaer AJ, Bia MJ, Lifton RP, Simon DB. Gitelman's syndrome revisited: an evaluation of symptoms and health-related quality of life. Kidney Int. 2001; 59 ((2)) 710-717
- 6 Ahlawat SK, Gupta S. Hypokalemic paralysis. J Assoc Physicians India. 1994; 42 ((3)) 260-261
- 7 Landau D. Potassium-related inherited tubulopathies. Cell Mol Life Sci. 2006; 63 ((17)) 1962-1968
- 8 Lin SH, Chiu JS, Hsu CW, Chau T. A simple and rapid approach to hypokalemic paralysis. Am J Emerg Med. 2003; 21 ((6)) 487-491
- 9 Lin SH, Lin YF, Chen DT, Chu P, Hsu CW, Halperin ML. Laboratory tests to determine the cause of hypokalemia and paralysis. Arch Intern Med. 2004; 164 ((14)) 1561-1566
- 10 Jeck N, Konrad M, Peters M, Weber S, Bonzel KE, Seyberth HW. Mutations in the chloride channel gene, CLCNKB, leading to a mixed Bartter-Gitelman phenotype. Pediatr Res. 2000; 48 ((6)) 754-758
- 11 Mastroianni N, Bettinelli A, Bianchetti M. et al . Novel molecular variants of the Na-Cl cotransporter gene are responsible for Gitelman syndrome. Am J Hum Genet. 1996; 59 ((5)) 1019-1026
- 12 Cheng NL, Kao MC, Hsu YD, Lin SH. Novel thiazide-sensitive Na-Cl cotransporter mutation in a Chinese patient with Gitelman's syndrome presenting as hypokalaemic paralysis. Nephrol Dial Transplant. 2003; 18 ((5)) 1005-1008
- 13 Nishihara G, Higashi H, Matsuo S, Yasunaga C, Sakemi T, Nakamoto M. Acute renal failure due to hypokalemic rhabdomyolysis in Gitelman's syndrome. Clin Nephrol. 1998; 50 ((5)) 330-332
- 14 Tang NL, Hui J, To KF, Ng HK, Hjelm NM, Fok TF. Severe hypokale-mic myopathy in Gitelman's syndrome. Muscle Nerve. 1999; 22 ((4)) 545-547
- 15 Pela I, Materassi M, Seracini D, Lavoratti G, Bettinelli A. Hypokalemic rhabdomyolysis in a child with Bartter's syndrome. Pediatr Nephrol. 2005; 20 ((8)) 1189-1191
Correspondence
B. AkinciMD
Division of Endocrinology of Metabolism
Department of Internal Medicine
Dokuz Eylul University Medical School
Inciralti
35340 Izmir
Turkey
Telefon: +90/232/412 37 44
Fax: +90/232/279 22 67
eMail: baris.akinci@deu.edu.tr