Gitelman's syndrome presenting as recurrent paralytic ileus due to chronic renal tubular K+ wasting.
Gitelman' syndrome, although a relatively frequent cause of chronic hypokalemia in adults, is rarely diagnosed correctly. It is frequently confused with overt diuretic abuse or Bartter's syndrome. We describe a 60 year man with 2 year history of recurrent paralytic ileus attributed to recurrent hypokalemia. Investigations in this patient revealed hypokalemia, metabolic alkalosis, hypocalciurea, and hypomagnesemia a tetrad diagnostic of Gitelman's syndrome. The peculiar clinical features of this condition and its management are discussed.
Internal Medicine, Service, Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India.
Uma
U
Sundar
Yogesh
Y
Lakkas
Dnyaneswar
D
Asole
Meghana
M
Vaidya
D000471:Alkalosis / Q000209:etiology / Q000378:metabolism; D001477:Bartter Syndrome / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004232:Diuretics / Q000008:administration & dosage; D053579:Gitelman Syndrome / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007008:Hypokalemia / Q000209:etiology* / Q000378:metabolism; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology*; D007684:Kidney Tubules / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011189:Potassium Chloride / Q000008:administration & dosage; D012008:Recurrence; D013148:Spironolactone / Q000008:administration & dosage; D013577:Syndrome; D016896:Treatment Outcome
D004232:Diuretics; D013148:Spironolactone; D011189:Potassium Chloride; D002118:Calcium