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CASE REPORT
Differential diagnosis for chronic hypokalaemia
  1. Laura Stimson1,
  2. Tim Reynolds2
  1. 1 Burton Hospitals NHS Foundation Trust, Burton on Trent, UK
  2. 2 Clinical Chemistry, Queen’s Hospital, Burton on Trent, UK
  1. Correspondence to Dr Laura Stimson, laurastimson{at}nhs.net

Summary

Doctors will often see patients with chronic hypokalaemia, frequently this is secondary to gastrointestinal losses, diuretics or renal disease. However, in this case report we review a rarer cause of chronic hypokalaemia—Gitelman syndrome (GS).

GS is an uncommon genetic disorder which causes primary renal tubular hypokalaemic metabolic alkalosis with secondary hypomagnesaemia and hypocalciuria. Although rare, it is important to remember GS when considering differential diagnoses for chronic hypokalaemia. We report the case of a woman who presented to the ophthalmology department with sclerochoroidal calcification. An ophthalmologist was reviewing the medical literature, which prompted them to investigate for GS. A diagnosis was formed at that time based on the blood and urine chemistry results. However, later we were able to offer the patient genetic testing, which confirmed our provisional diagnosis.

  • renal system
  • genetic screening / counselling
  • fluid electrolyte And acid-base disturbances

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Footnotes

  • Contributors Written by LS. TR contributed to writing of the case report and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.