title: Gitelman-like Syndrome with Kanamycin Toxicity.
abstract: A 22 year-old lady with multi-drug-resistant pulmonary tuberculosis was on Kanamycin, Cycloserine, Ethionamide, Pyrazinamide and Moxifloxacin since more than two months. She presented with muscle cramps and carpopedal spasm. Investigation revealed hypokalemia and metabolic alkalosis. She also had hypomagnesemia, hypochloremia and hypocalciuria. Serum urea and creatinine levels were normal. Patient was treated with intravenous and oral potassium chloride. Kanamycin was stopped. Metabolic alkalosis and hypokalemia improved gradually over one month. Biochemical parameters were like Gitelman's syndrome but it reversed with stoppage of Kanamycin. Gitelman-like syndrome with Kanamycin toxicity has not been reported in literature previously.
authors.affiliation: Associate Professor, Dept. of Medicine, Midnapore Medical College, Paschim Medinipur, West Bengal.
authors.forename: Gouranga
authors.initials: G
authors.lastname: Santra
authors.affiliation: Assistant Professor.
authors.forename: Rudrajit
authors.initials: R
authors.lastname: Paul
authors.affiliation: Postgraduate Trainee, Dept. of Medicine, Medical College, Kolkata, West Bengal.
authors.forename: Avik
authors.initials: A
authors.lastname: Karak
authors.affiliation: Postgraduate Trainee, Dept. of Medicine, Medical College, Kolkata, West Bengal.
authors.forename: Somnath
authors.initials: S
authors.lastname: Mukhopadhay
mesh_terms: D000328:Adult; D000471:Alkalosis / Q000139:chemically induced*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003523:Cycloserine / Q000008:administration & dosage / Q000009:adverse effects; D005000:Ethionamide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced*; D007612:Kanamycin / Q000008:administration & dosage / Q000009:adverse effects*; D000077266:Moxifloxacin; D009120:Muscle Cramp / Q000209:etiology; D011188:Potassium / Q000008:administration & dosage* / Q000097:blood; D011718:Pyrazinamide / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D024841:Fluoroquinolones; D011718:Pyrazinamide; D007612:Kanamycin; D003523:Cycloserine; D005000:Ethionamide; D011188:Potassium; D000077266:Moxifloxacin