[Gitelman syndrome in children: true hypokalemia but false Bartter syndrome].
BACKGROUND
Gitelman's syndrome or familial hypokalemia-hypomagnesemia and Bartter syndrome share some common features but their prognosis is quite different.


METHODS
Four unrelated children, aged 5 to 12 years, were studied because they suffered from muscle cramps and/or abdominal pain. Supportive findings included: hypokalemia (2.1 to 2.9 mmol/l), metabolic alkalosis (31 to 34 mmol/l), hyperkaliuresis (5.8 to 7.1 mmol/kg/day), hypomagnesemia (0.58 to 0.64 mmol/l), hypermagnesuria (0.19 to 0.23 mmol/kg/day), hypocalciuria (0.012 to 0.021 mmol/kg/day). Blood pressure contrasting with high renin activity (19.04 to 20.03 ng/ml/hr) was normal. Chloride fractional excretion after oral water supplementation was only slighty decreased and hypercalciuric response to furosemide administration was not observed. Supplementation with magnesium chloride failed to correct hypomagnesemia while potassium chloride improved hypokalemia.


CONCLUSIONS
Age of onset, tetany manifestations, absence of growth retardation, hypermagnesuria despite, hypomagnesemia, hypocalciuria not improved by furosemide favor the diagnosis of Gitelman's syndrome rather than that of Bartter syndrome initially considered.
Fischbach
M
M
Service de pédiatrie 1, hôpitaux universitaires de Strasbourg, hôpital de hautepierre, France.
Hoellinger
M J
MJ
Tersic
J
J
Matz
B
B
Mengus
L
L
Desprez
P
P
Chaigne
D
D
Stoll
C
C
Taimi
A
A
Simeoni
U
U
D001477:Bartter Syndrome / Q000175:diagnosis*; D002118:Calcium / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007008:Hypokalemia / Q000150:complications* / Q000235:genetics; D008274:Magnesium / Q000652:urine; D008275:Magnesium Deficiency / Q000150:complications* / Q000235:genetics; D013577:Syndrome; D013746:Tetany / Q000150:complications
D008274:Magnesium; D002118:Calcium
Syndrome de Gitelman chez l'enfant: vraie hypokaliémie mais faux syndrome de Bartter.