Hipertiroidili Bir Hastada Hipokaleminin Nadir Nedeni: Gitelman Sendromu

Hipokalemi sık görülen elektrolit bozukluklarından biridir. Azalmış potasyum alımı, hücre içine artmışpotasyum geçişi, gastrointestinal sistemden ya da üriner sistemden artmış potasyum kaybı, ilaçlar gibipek çok faktör hipokalemiye neden olabilir. Gitelman sendromu hipokaleminin eşlik ettiği nadir görülenotozomal resesif hastalıktır. Burada hipertiroidi nedeniyle tetkik edilirken Gitelman sendromu tanısıkonulan bir olguyu sunduk.

A Rare Reason of Hypokalemia in a Hyperthyroid Patient: Gitelman Syndrome

Hypokalemia is one of the commonly observed electrolyte disturbances. Many factors like decreased potassium intake, increased intracellular potassium influx, increased excretion from the gastrointestinal system or urinary tract, and drugs can cause hypokalemia. Gitelman syndrome is a rare autosomal recessive disease associated with hypokalemia. Here, we presented a case who was examined for hyperthyroidism and finally diagnosed as Gitelman syndrome.

___

  • 1. Monnens L, Bindels R, Grünfeld JP. Gitelman syndrome comes of age. Nephrol Dial Transplant 1998;13(7):1617‐9.
  • 2. Blanchard A, Bockenhauer D, Bolignano D, et al. Gitelman syndrome: consensus and guidance from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int 2017;91(1):24‐33.
  • 3. Cruz DN, Simon DB, Nelson‐Williams C, et al. Mutations in the Na‐Cl cotransporter reduce blood pressure in humans. Hypertension 2001;37(6):1458‐64.
  • 4. De Jong JC, Van Der Vliet WA, Van Den Heuvel LP, Willems PH, Knoers PH, Bindels RJ. Functional expression of mutations in the human NaCl cotransporter: evidence for impaired routing mechanisms in Gitelman's syndrome. J Am Soc Nephrol 2002;13(6):1442‐8.
  • 5. Vargas‐Poussou R, Dahan K, Kahila D, et al. Spectrum of mutations in Gitelman syndrome. J Am Soc Nephrol 2011;22(4):693‐703.
  • 6. Ea HK, Blanchard A, Dougados M, Roux C. Chondrocalcinosis secondary to hypomagnesemia in Gitelman's syndrome. J Rheumatol 2005;32(9):1840‐2.
  • 7. Berry MR, Robinson C, Karet Frankl FE. Unexpected clinical sequelae of Gitelman syndrome: hypertension in adulthood is common and females have higher potassium requirements. Nephrol Dial Transplant 2013;28(6):1533‐42.
  • 8. Stein JH. The pathogenetic spectrum of Bartter's syndrome. Kidney Int 1985;28(1):85‐93.
  • 9. Blanchard A, Vargas‐Poussou R, Vallet M, et al. Indomethacin, amiloride, or eplerenone for treating hypokalemia in Gitelman syndrome. J Am Soc Nephrol 2015;26(2):468‐75.
  • 10. Calo LA, Marchini F, Davis PA, Rigotti P, Pagnin E, Semplicini A. Kidney transplant in Gitelman's syndrome. Report of the first case. J Nephrol 2003;16(1):144‐7.