Geletu Abeselom, Gardner-Gray Jayna, Roche Meaghan, Ngassa Marina
Internal Medicine, Henry Ford Health System, Detroit, USA.
Critical Care Medicine, Henry Ford Health System, Detroit, USA.
Cureus. 2023 Jan 9;15(1):e33565. doi: 10.7759/cureus.33565. eCollection 2023 Jan.
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.
吉特曼综合征是一种失盐性肾小管病，其特征为严重低钾血症、低镁血症、代谢性碱中毒和低钙尿症。心脏骤停是吉特曼综合征相对罕见的表现。在此，我们报告一例反复发生心脏骤停的吉特曼综合征患者。一名43岁女性因室颤导致院外心脏骤停入院。初始检查发现严重低钾血症、低镁血症、代谢性碱中毒和QTc延长。检查显示为失盐性肾小管病，伴有低钾血症、低镁血症和低钙尿症。积极补充钾，患者接受了保钾药物治疗，血钾水平得以稳定。出院前，植入了植入式心律转复除颤器（ICD）以二级预防心脏骤停。患者无症状，电解质保持稳定。该病例突出了吉特曼综合征的诊断挑战以及准确诊断对改善患者预后的重要性。
