Ann Pediatr Endocrinol Metab.  2013 Mar;18(1):36-39. 10.6065/apem.2013.18.1.36.

Gitelman syndrome combined with complete growth hormone deficiency

Affiliations
  • 1Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea. ahn74@kangwon.ac.kr
  • 2Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 3Research Coordination Center for Rare Diseases, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 4Kidney Research Institute, Medical Research Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Gitelman syndrome is a rare autosomal recessive hereditary salt-losing tubulopathy, that manifests as hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalciuria. It is caused by mutations in the solute carrier family 12(sodium/chloride transporters), member 3 (SLC12A3) gene encoding the thiazide-sensitive sodium chloride cotransporter channel (NCCT) in the distal convoluted tubule of the kidney. It is associated with muscle weakness, cramps, tetany, vomiting, diarrhea, abdominal pain, and growth retardation. The incidence of growth retardation, the exact cause of which is unknown, is lower than that of Bartter syndrome. Herein, we discuss the case of an overweight 12.9-year-old girl of short stature presenting with hypokalemic metabolic alkalosis. The patient, on the basis of detection of a heterozygous mutation in the SLC12A3 gene and poor growth hormone (GH) responses in two provocative tests, was diagnosed with Gitelman syndrome combined with complete GH deficiency. GH treatment accompanied by magnesium oxide and potassium replacement was associated with a good clinical response.

Keyword

Gitelman syndrome; Sodium Chloride Symporters; Growth hormone

MeSH Terms

Abdominal Pain
Alkalosis
Bartter Syndrome
Diarrhea
Gitelman Syndrome
Growth Hormone
Humans
Incidence
Kidney
Magnesium Oxide
Muscle Cramp
Muscle Weakness
Overweight
Potassium
Sodium Chloride Symporters
Tetany
Vomiting
Growth Hormone
Magnesium Oxide
Potassium
Sodium Chloride Symporters

Figure

  • Fig. 1 Heterozygous mutations were detected in exon 3 and 15 of SLC12A3 gene. (A) a heterozygous c.494A>T (p.Gln165Leu) in exon 3, (B) a heterozygous c.1868T>C (p.Leu623Pro) in exon 15.


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