Clinical and genetic analysis of a case of Gitelman syndrome accompanied with Graves disease and adrenocortical adenoma: A case report

Medicine (Baltimore). 2024 Apr 12;103(15):e37770. doi: 10.1097/MD.0000000000037770.

Abstract

Rationale: Gitelman syndrome (GS), also known as familial hypokalemia and hypomagnesemia, is a rare autosomal recessive inherited disease caused by primary renal desalinization caused by impaired reabsorption of sodium and chloride ions in the distal renal tubules. We report a case of clinical and genetic characteristics of GS accompanied with Graves disease and adrenocorticotrophic hormone (ACTH)-independent adrenocortical adenoma.

Patient concerns: The patient is a 45 year old female, was admitted to our hospital, due to a left adrenal gland occupying lesion as the chief complaint.

Diagnosis: The patient was finally diagnosed as GS with Graves disease and adrenocortical adenoma.

Interventions: Potassium magnesium aspartate (1788 mg/d, taken orally 3 times a day (supplement a few times a day, intake method, treatment duration). Contains 217.2 mg of potassium and 70.8 mg of magnesium, and potassium chloride (4.5 g/d, taken orally 3 times a day (supplement a few times a day, intake method, and treatment duration); Potassium 2356 mg), spironolactone (20 mg/d, taken orally once a day (supplement a few times a day, intake method, treatment duration). After 3 months of treatment, the patient's blood potassium fluctuated between 3.3-3.6 mmol/L, and blood magnesium fluctuated between 0.5-0.7 mmol/L, indicating a relief of fatigue symptoms.

Outcomes: On the day 6 of hospitalization, the symptoms of dizziness, limb fatigue, fatigue and pain were completely relieved on patient. In the follow-up of the following year, no recurrence of the condition was found.

Lessons: The novel c.1444-10(IVS11)G > A variation may be a splicing mutation. The compound heterozygous mutations of the SLC12A3 gene may be the pathogenic cause of this GS pedigree.

Publication types

  • Case Reports

MeSH terms

  • Adrenocortical Adenoma*
  • Fatigue
  • Female
  • Gitelman Syndrome* / complications
  • Gitelman Syndrome* / diagnosis
  • Gitelman Syndrome* / genetics
  • Graves Disease* / complications
  • Graves Disease* / genetics
  • Humans
  • Magnesium
  • Middle Aged
  • Potassium
  • Solute Carrier Family 12, Member 3

Substances

  • Magnesium
  • Potassium
  • SLC12A3 protein, human
  • Solute Carrier Family 12, Member 3