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青少年女性孕期首次诊断吉特曼综合征:一例报告

First Diagnosis of Gitelman Syndrome During Pregnancy in an Adolescent Female: A Case Report.

作者信息

Zacharis Konstantinos, Alexakis Chalent, Tsapadikou Vasiliki K, Anagnostaki Ismini, Charitos Theodoros

机构信息

Department of Obstetrics and Gynaecology, General Hospital of Lamia, Lamia, GRC.

出版信息

Cureus. 2024 May 4;16(5):e59644. doi: 10.7759/cureus.59644. eCollection 2024 May.

Abstract

Gitelman syndrome (GS) is an inherited somatic recessive disorder characterized by hypokalemic metabolic alkalosis, accompanied by hypocalciuria and hypermagnesuria. It usually presents in late childhood or young adults with muscle weakness, tetany, or convulsions. Limited information is available in the literature regarding the proper management of this syndrome during pregnancy, as well as its effects on both the mother and the child. We herein present the case of a 16-year-old primigravida who was admitted to the emergency department with chief complaints of abdominal pain, weakness, and vomiting for the past three days during the 12th week of gestation. Routine blood investigations revealed hypokalemia and hypomagnesemia, and electrocardiography (ECG) showed ST-segment depressions. Further evaluation was performed due to persistent hypokalemia, and metabolic alkalosis, hypocalciuria, and hyperaldosteronism were found. Hence, a clinical diagnosis of GS took place. The pregnancy progressed smoothly without complications; potassium levels remained consistently below normal, requiring supplementation three times during pregnancy. Pregnant women with GS should be reported due to the rarity of cases, aiming to establish a standardized approach for monitoring and management.

摘要

吉特林综合征(GS)是一种遗传性常染色体隐性疾病,其特征为低钾性代谢性碱中毒,并伴有低钙尿症和高镁尿症。它通常在儿童晚期或青年期出现,表现为肌肉无力、手足搐搦或惊厥。关于该综合征在孕期的恰当管理及其对母亲和胎儿的影响,文献中的信息有限。我们在此报告一例16岁初产妇的病例,她在妊娠12周时因腹痛、乏力和呕吐为主诉,于过去三天入住急诊科。常规血液检查显示低钾血症和低镁血症,心电图(ECG)显示ST段压低。由于持续性低钾血症进行了进一步评估,发现有代谢性碱中毒、低钙尿症和醛固酮增多症。因此,临床诊断为GS。妊娠过程顺利无并发症;钾水平持续低于正常,孕期需要补充三次。鉴于病例罕见,应报告患有GS的孕妇,旨在建立标准化的监测和管理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1550/11146675/8c7379711788/cureus-0016-00000059644-i01.jpg

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