Hypocalcaemia and hyponatraemia masquerading the diagnosis of Gitelman syndrome

Bhargav Gopinath, Nupur Chauhan, Basavaprabhu Achappa

Research output: Contribution to journalArticle

Abstract

Gitelman syndrome is the most common renal tubulopathy, recently exhibiting a dramatic rise of incidence in Asia. A 50-year-old woman presented with vomiting, fatigue and quadriparesis. Physical examination revealed a positive Trousseau sign, hypotonia and areflexia. Suspecting hypocalcaemia, she was given intravenous 10% calcium gluconate (10 mL administered slowly over 10 min) but her manifestations persisted. An exhaustive laboratory work up revealed the diagnosis of Gitelman syndrome. The peculiarity of this case however, is entailed in its coexistence with hypocalcaemia and hyponatraemia. In addition, the age of primary presentation being 50 years further culminates its atypicality. Multiple electrolyte imbalances were corrected by oral and intravenous supplementation and a high sodium-potassium diet was advocated. Administration of spironolactone imposed a pitfall in the management of our patient due to exacerbation of pre-existing hyponatraemia. On follow-up, her electrolyte profile was stable and corresponding symptoms were alleviated.

Original languageEnglish
Article numbere227886
JournalBMJ Case Reports
Volume12
Issue number1
DOIs
Publication statusPublished - 01-01-2019

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Gitelman Syndrome
Hypocalcemia
Hyponatremia
Electrolytes
Calcium Gluconate
Spironolactone
Muscle Hypotonia
Quadriplegia
Physical Examination
Vomiting
Fatigue
Potassium
Sodium
Diet
Kidney
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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Hypocalcaemia and hyponatraemia masquerading the diagnosis of Gitelman syndrome. / Gopinath, Bhargav; Chauhan, Nupur; Achappa, Basavaprabhu.

In: BMJ Case Reports, Vol. 12, No. 1, e227886, 01.01.2019.

Research output: Contribution to journalArticle

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