Loss of consciousness and hypokalemia in an elderly man with a mutation of the thiazide-sensitive Na-Cl cotransporter gene.
An 80-year-old man was referred to our department for evaluation of repetitive loss of consciousness and faintness with hypokalemia. He had relatively low blood pressure, hypomagnesemia, hypocalciuria and chondrocalcinosis in the knee, clinically suggesting Gitelman's syndrome. A renal clearance study could not be carried out due to the patient's age and complications of the heart. Sequence analysis of the gene of thiazide-sensitive Na-Cl cotransporter (TSC) showed a heterozygous missense mutation from C to T at 1712 base pairs from the translation start site, with resultant changes in codon 569 from alanine to valine (A569V). Treatment with oral administration of potassium chloride improved all the symptoms. Although Gitelman's syndrome has been considered to be autosomal recessive, cases of only heterozygous mutation detected have recently been reported. Therefore, the mutation found in this patient may be responsible for Gitelman's syndrome.
Hashida
Tetsu
T
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Yamada
Masanobu
M
Hashimoto
Koshi
K
Satoh
Tetsuro
T
Okada
Shuichi
S
Shibusawa
Nobuyuki
N
Ishizuka
Takahiro
T
Mori
Masatomo
M
D000369:Aged, 80 and over; D001483:Base Sequence; D004252:DNA Mutational Analysis; D053579:Gitelman Syndrome / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D007008:Hypokalemia / Q000150:complications / Q000235:genetics*; D008297:Male; D008954:Models, Biological; D011955:Receptors, Drug / Q000235:genetics*; D049992:Sodium Chloride Symporters / Q000235:genetics*; D014474:Unconsciousness / Q000150:complications / Q000235:genetics*
D011955:Receptors, Drug; D049992:Sodium Chloride Symporters; C064415:thiazide receptor