Heart's Dangerous Symphony: Torsade De Pointes Unleashed by Gitelman Syndrome-Induced Hypomagnesemia

Cureus. 2023 Aug 31;15(8):e44464. doi: 10.7759/cureus.44464. eCollection 2023 Aug.

Abstract

Gitelman syndrome (GS) is a rare autosomal recessive salt-losing renal tubular disorder associated with a mutation of SLC12A3 or CLCNKB genes which encodes the thiazide-sensitive sodium-chloride co-transporter (NCCT) in the distal renal tubule. It is inherited as an autosomal recessive disorder. Hypokalemia, metabolic alkalosis, hypomagnesemia, hypocalciuria, and renin-angiotensin-aldosterone system (RAAS) activation are characteristics of GS. GS is often misdiagnosed or underdiagnosed owing to its low incidence and lack of awareness. Its prevalence is estimated to be around 1-10 per 40,000 people. We report a case of cardiac arrest secondary to torsade de pointes (TdP) because of GS-induced hypomagnesemia. Our case highlights the importance of clinicians being aware of the potential electrolyte abnormalities and complications associated with GS, as it can lead to catastrophic consequences if not identified and corrected earlier.

Keywords: cardiac arrest; cardiopulmonary resuscitation; fatal arrhythmia; gitelman syndrome; hypomagnesemia; prolonged qtc interval; renal tubular disorder; torsades de pointes (tdp); ventricular arrhythmias (vas); wet beri-beri syndrome.

Publication types

  • Case Reports