Introduction.
Gitelman's syndrome (GS) is autosomal recessive renal tubular disorder characterized by
hypokalemia, hypomagnesemia, hypocalciuria, metabolic
alkalosis, and hyperreninemic
hyperaldosteronism. It is usually associated with normal serum
calcium. We report a patient presented with hypocalcemic
tetany, and evaluation showed
Gitelman's syndrome with
hypocalcemia. Case Report. A 28-year-old woman presented with
cramps of the arms, legs,
fatigue, and carpal
spasms of one week duration. She has history of similar episodes on and off for the past two years. Her blood pressure was 98/66 mmHg. Chvostek's sign and Trousseau's sign were positive. Evaluation showed
hypokalemia,
hypocalcemia, hypomagnesemia, metabolic
alkalosis, and hypocalciuria.
Self-medication,
diuretic use,
laxative abuse, persistent
vomiting, and diarrhoea were ruled out. Urinary
prostaglandins and genetic testing could not be done because of nonavailability. To differentiate
Gitelman syndrome from
Bartter's syndrome (BS),
thiazide loading test was done. It showed blunted fractional
chloride excretion. GS was confirmed and patient was treated with
spironolactone along with
magnesium,
calcium, and
potassium supplementation. Symptomatically, she improved and did not develop episodes of
tetany again. Conclusion. In
tetany patient along with serum
calcium measurement, serum
magnesium, serum
potassium, and arterial blood
gases should be measured. Even though
hypocalcemia in
Gitelman syndrome is rare, it still can occur.