Eplerenone improved hypokalemia in a patient with Gitelman's syndrome.
A 47-year-old woman presented with hypokalemia (2.4 mmol/L). She also had hypomagnesemia, hypocalciuria, and hyperreninemic hyperaldosteronism. Sequence analysis revealed a compound heterozygous mutation, R655C and R955Q, in the SLC12A3 gene. These findings were compatible with Gitelman's syndrome (GS). Eplerenone, a selective aldosterone blocker, in combination with oral potassium chloride improved serum potassium level (3.6 mmol/L) with no apparent adverse effect. Although eplerenone has an advantage over spironolactone for its selective affinity for the aldosterone receptor, the efficacy and safety of eplerenone for GS is little understood. Our observation suggests that eplerenone is a useful treatment option for GS.
Department of Endocrinology and Diabetes, Nagoya Ekisaikai Hospital, Japan.
Yukiko
Y
Ito
Masanori
M
Yoshida
Mikihiro
M
Nakayama
Shoji
S
Tsutaya
Koichiro
K
Ogawa
Harumi
H
Maeda
Misaki
M
Miyata
Yutaka
Y
Oiso
D001483:Base Sequence; D004252:DNA Mutational Analysis; D000077545:Eplerenone; D005260:Female; D053579:Gitelman Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology* / Q000235:genetics; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D020125:Mutation, Missense; D011188:Potassium / Q000097:blood; D011955:Receptors, Drug / Q000235:genetics; D064486:Solute Carrier Family 12, Member 3; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D027981:Symporters / Q000235:genetics; D016896:Treatment Outcome
D000451:Mineralocorticoid Receptor Antagonists; D011955:Receptors, Drug; C578874:SLC12A3 protein, human; D064486:Solute Carrier Family 12, Member 3; D027981:Symporters; D013148:Spironolactone; D000077545:Eplerenone; D011188:Potassium