Successful treatment by cyclooxyenase-2 inhibitor of refractory hypokalemia in a patient with Gitelman's syndrome.
Gitelman's syndrome is manifested by hypokalemic alkalosis, hypomagnesemia, hypocalciuria, normotensive hyperreninemia and hyperaldosteronism. Hypokalemia can at times be refractory to treatment. We present a patient refractory to a variety of drugs including indomethacin, the nonspecific COX inhibitor. Rofecoxib, a specific COX 2 inhibitor, promptly elevated serum potassium concentration with normalization of plasma aldosterone and near normalization of renin without a change in serum magnesium. Our patient also had rhabdomyolysis, a rarely reported complication, which was also ameliorated by COX 2 inhibition.
Department of Medicine E, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Israel. mayan@post.tau.ac.il
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Mayan
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Gurevitz
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Farfel
D000328:Adult; D000471:Alkalosis / Q000188:drug therapy; D002118:Calcium / Q000652:urine; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D006929:Hyperaldosteronism; D007008:Hypokalemia / Q000175:diagnosis / Q000188:drug therapy*; D007783:Lactones / Q000627:therapeutic use*; D008274:Magnesium / Q000097:blood; D008297:Male; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000188:drug therapy*; D013450:Sulfones; D013577:Syndrome; D016896:Treatment Outcome
D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib; D008274:Magnesium; D002118:Calcium