A RARE CASE OF PERSISTENT HYPOKALEMIA, HYPOCALCIURIA AND METABOLIC ALKALOSIS IN A YOUNG PATIENT: GITELMAN’S SYNDROME

Gitelman’s syndrome(GS) is characterized by persistant hypokalemia, metabolic alkalosis and hypocalciuria. Persistant hypokalemia is the main finding of patients with GS. GS is more frequently diagnosed in adolescence or adulthood. Patients with GS usually have a normal blood pressure. We herein report a 21 year-old male patient with persistant hypokalemia, mild metabolic alkalosis, hypocalciuria, generalised muscle cramps and weakness. The laboratory data revealed a potassium concentration of 2.3 mmol/l. He had never used diuretics or antihypertensive drugs and he had not had any history of vomiting or diarrhea. The physical findings were unremarkable; particularly his blood pressure was within the normal range. The serum calcium concentration was normal but he had slight hypocalciuria. Oral and intravenous potassium suplementation with an aldosterone antagonist were given as a therapy to the patient, but he remained hypokalemic. Although the hypokalemia of the patients with GS is usually well tolerated, it sometimes can cause life threatening situations. To define the aetiology of hypokalemia, physician might have to analyse serum and urine electrolytes and blood gas. Consequently, the treatment of a patient with GS must be closely monitored in life-long.