Gitelman’s syndrome presenting with hypocalcemic tetany and hypokalemic periodic paralysis

Abstract EN

Gitelman’s syndrome is an autosomal recessive renal tubular disorder characterized by hypomagnesemia, hypokalemia, hypocalciuria, and metabolic alkalosis.

Hypocalcemic tetany as a presentation of Gitelman’s syndrome has rarely been reported in literature.

We report a rare case of Gitelman’s syndrome presenting with hypocalcemic tetany along with hypokalemic periodic paralysis.

A 17-year-old female was admitted to our hospital with a history of perioral numbness and carpal spasms of five days duration with progressive quadriparesis developing over a period of few hours.

Past history was significant for three episodes of transient lower limb weakness.

On examination, blood pressure was 110/70 mm Hg.

Chvostek’s sign and Trousseau’s sign were positive.

Neurologically, she was fully oriented.

She had Grade 3 power in all the four limbs with intact sensation.

Laboratory tests showed hypocalcemia (7.8 mg/dL), hypokalemia (2.2 mEq/L), hypomagnesemia (0.9 mEq/L), and hypocalciuria (104 mg/day).

Arterial blood gas showed mild metabolic alkalosis with respiratory compensation.

Thus, a clinical diagnosis of GS was made.

The patient made a remarkable recovery after the correction of electrolyte imbalance.

The aim of this case report is to re-emphasize the fact that hypocalcemia can rarely occur in Gitelman’s syndrome.