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Localised normocalcaemic tetany secondary to dehydration in an individual with Gitelman syndrome
Hardeep Singh Kalsi1, Michael Kim, Anmar Alkhamesi
1Department of Accident & Emergency, North Middlesex University Hospital, London, Greater London, UK. hkalsi65@gmail.com
Abstract:
Dehydration is a common presentation to any emergency department with symptoms ranging from lethargy, confusion, oliguria as well as those specific to the underlying cause. In this case we describe a young patient who following a short history of vomiting and abdominal pain developed carpopedal spasm and distal parasthesia on a background of Gitelman syndrome. Biochemical blood analysis showed a marked hypokalaemia, hypomagnesaemia and mild metabolic alkalosis in addition to a prolonged QTc interval of 592 ms seen on ECG. Following fluid replacement and electrolyte correction his clinical symptoms resolved along with QTc normalisation. This case demonstrates a patient with a rare and interesting renal disorder who presented with typical biochemical and ECG abnormalities in addition to tetany in the presence of normal plasma calcium.
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