Cardiac Arrest as the First Presentation of Gitelman Syndrome

Gitelman syndrome is a salt-wasting tubulopathy characterized by profound hypokalemia, hypomagnesemia, metabolic alkalosis, and hypocalciuria. Cardiac arrest is a relatively rare manifestation of Gitelman syndrome. Here we present a case of Gitelman syndrome in a patient with recurrent cardiac arres...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-01, Vol.15 (1), p.e33565
Main Authors: Geletu, Abeselom, Gardner-Gray, Jayna, Roche, Meaghan, Ngassa, Marina
Format: Article
Language:English
Subjects:
Alkalosis
Asymptomatic
Cardiac arrest
Cardiac arrhythmia
Case reports
Convulsions & seizures
Creatinine
Disease prevention
Diuretics
Electrocardiography
Electrolytes
Emergency medical care
Hypokalemia
Intensive care
Metabolism
Nephrology
Potassium
Urine
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Summary:Gitelman syndrome is a salt-wasting tubulopathy characterized by profound hypokalemia, hypomagnesemia, metabolic alkalosis, and hypocalciuria. Cardiac arrest is a relatively rare manifestation of Gitelman syndrome. Here we present a case of Gitelman syndrome in a patient with recurrent cardiac arrest. A 43-year-old female was admitted for out-of-hospital cardiac arrest secondary to ventricular fibrillation. Initial workup revealed severe hypokalemia, hypomagnesemia, metabolic alkalosis, and prolonged QTc. The workup revealed a picture of salt-wasting tubulopathy with hypokalemia, hypomagnesemia, and hypocalciuria. Potassium was repleted aggressively, and the patient received potassium-sparing agents resulting in the stabilization of potassium levels. Before discharge, an implantable cardioverter defibrillator (ICD) was placed for secondary prevention of cardiac arrest. The patient remained symptom-free, and electrolytes remained stable. This case highlights the diagnostic challenges of Gitelman syndrome and the importance of accurate diagnosis in improving patient outcomes.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.33565