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KMID : 0388420020120010189
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Konkuk Journal of Medical Sciences
2002 Volume.12 No. 1 p.189 ~ p.197
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A Case of Pseudo-Gitelman´s Syndrome
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Kim Sung-Ryel
Jo Young-Il
Lee Hae-Woon
Lee Jeong-Yeon
Ahn Hae-Lyun
Song Jong-Oh
Myung Seung-Woon
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Abstract
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Gitelman´s syndrome is a rare disorder with a characteristic set of metabolic abnormalities. These include hypokalemia, metabolic alkalosis, hypocalciuria and hypomagnesemia. The clinical manifestations of Gitelman´s syndrome are very similar with those of Bartter´s syndrome and diuretic abuse. Gitelman´ syndrome
and Bartter´s syndrome can be distinguished by renal clearance study after a
administration of furosemide and thiazide, since the primary defect in each of
these disorders is an impairment in sodium reabsorption in the distal tubule and loop of Henle, respectively. Pseudo-Bartter´s syndrome due to diuretic abuse can be distinguished by history of diuretic use and a positive urine assay for diuretics. We have experienced a case of pseudo-Gitelman´s syndrome in 56-year old woman with unexplained hypokalemic metabolic alkalosis, hypocalciuria, and hypomagnesemia. The patient denied ingestion of diuretic medication. The results of renal clearance study using furosemide and thiazide in this case suggested the presence of the primary defect of sodium reabsorption in the. distal tubule rather than in the loop of Henle. These clinical and laboratory findings were consistent with those of Gitelman´s syndrome. But, this case was confirmed as pseudo-Gitelman´s syndrome since diuretics were detected by a urine assay for diuretics. Furosemide and hydrochlorothiazide were contained in the pill that she had been taking due to constipation. Herein, we report the case of pseudo-Gitelman´s syndrome by abuse of cathartics containig diuretics presented as Gitelman´s syndrome in renal clearance study.
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KEYWORD
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Pseudo-Gitelman´s syndrome, Renal clearance study, Diuretic abuse
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