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Abnormal FDG Biodistribution in a Patient With Gitelman Syndrome
Yuka Yamamoto1, Katsuya Mitamura, Takashi Norikane
1From the Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Gitelman syndrome, a rare kidney disorder, presented with unusual 18F-FDG PET/CT findings. The patient showed abnormal glucose metabolism mimicking a high insulin state despite normal glucose and low insulin levels.
Area of Science:
- Medical Imaging
- Nephrology
- Endocrinology
Background:
- Gitelman syndrome is an autosomal recessive renal tubulopathy.
- A 38-year-old woman with diagnosed Gitelman syndrome underwent imaging for endometrial cancer recurrence.
Observation:
- 18F-FDG PET/CT revealed an abnormal pattern of radiotracer biodistribution.
- Key observations included decreased brain uptake and increased uptake in cardiac muscle, skeletal muscle, and adipose tissue.
Findings:
- The observed FDG uptake pattern mimicked a state of high insulin action.
- This occurred despite the patient presenting with normal glucose levels and very low insulin levels.
Implications:
- This case highlights a potential, previously undescribed metabolic consequence of Gitelman syndrome.
- The findings suggest a need to consider Gitelman syndrome when interpreting atypical FDG PET/CT biodistribution patterns, especially in patients with normal glucose and low insulin.
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