A clinical analysis of 9 cases of Gitelman syndrome

Objective To analyze the clinical characteristics of Gitelman syndrome.Methods Clinical data of 9 cases of Gitelman syndrome seen in the past 25 years in Chinese PLA General Hospital were analyzed retrospectively.Results The age of onset of Gitelman syndrome was 14-33 years.Main symptoms included weakness,tetany,pelydipsia,pelyuria,nocturia and paralysis.All patients had normal blood pressure.The biochemical tests showed hypekalemic alkalosis(9/9),hypocalciuria and hypomagnesaemia(9/9),low urine Ca/Cr ratio(＜0.2,5/5)and hyperreninemia(9/9).Renal pathological examination showed juxtaglomerular apparatus hyperplasia(2/2).All the patients' symptoms were relieved after treatment with potassium and magnesium supplementation or with combined spironolactone and indomethacin.However,serum potassium and magnesium levels were still lower than normal range(8/9); only one patient's serum potassium recovered to normal level.Conclusion When clinical features such as weakness,hypokalemic alkalosis with normotension were encountered,Gitelman syndrome should be suspected.Serum magnesium as well as urine magnesium and calcium should be measured for confirmation of diagnosis.The treatment of choice included potassium and magnesium supplementation,or combination with anti-aldosterone medications,prostaglandin inhibitors and angiotensin-converting enzyme inhibitor. Generally,these patients have good prognosis.