A Case of Gitelman's Syndrome that was difficult to distinguish from Hypokalemic Periodic Paralysis due to Graves' Disease

Takeshi Oba; Shunsuke Kobayashi; Yuko Nakamura; Mototsugu Nagao; Kandai Nozu; Izumi Fukuda; kazumoto Iijima; Hitoshi Sugihara

doi:10.1272/jnms.JNMS.2019_86-505

This article has now been updated. Please use the final version.

A Case of Gitelman's Syndrome that was difficult to distinguish from Hypokalemic Periodic Paralysis due to Graves' Disease

Takeshi Oba, Shunsuke Kobayashi, Yuko Nakamura, Mototsugu Nagao, Kandai Nozu, Izumi Fukuda, kazumoto Iijima, Hitoshi Sugihara

Author information

Takeshi Oba
Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School
Shunsuke Kobayashi
Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School
Yuko Nakamura
Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School
Mototsugu Nagao
Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School
Kandai Nozu
Department of Pediatrics, Kobe University Graduate School of Medicine
Izumi Fukuda
Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School
kazumoto Iijima
Department of Pediatrics, Kobe University Graduate School of Medicine
Hitoshi Sugihara
Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School

Keywords: eplerenone, Gitelman's syndrome, thyrotoxic hypokalemic periodic paralysis, hypokalemia, SLC12A3 gene

JOURNAL FREE ACCESS Advance online publication

Article ID: JNMS.2019_86-505

DOI https://doi.org/10.1272/jnms.JNMS.2019_86-505

The final version of this article is now available: Vol. 86 (2019), No. 5 pp. 301-306

Details

Abstract

A 21-year-old man presented with hyperthyroidism and hypokalemia and was treated for thyrotoxic hypokalemic periodic paralysis (THPP) due to Graves' disease. Thyroid function soon normalized, but hypokalemia persisted. Laboratory data revealed hyperreninemic hyperaldosteronism and metabolic alkalosis consistent with Gitelman's Syndrome (GS). He was found to have a previously unreported compound heterozygous mutation of T180K and L858H in the SLC12A3 gene and was diagnosed with GS. He was started on eplerenone to control serum potassium levels. It is important to consider other diagnoses when electrolyte imbalances persist despite resolving disease.

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