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Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum

Cilt: 19 Sayı: 4 10 Ekim 2026
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Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum

Öz

Gitelman syndrome is an autosomal recessive tubulopathy caused by SLC12A3 mutations and typically presents with hypokalemia, metabolic alkalosis, and hypomagnesemia. However, atypical phenotypes are increasingly recognized. We report a four-year-old child with recurrent hypokalemia without hypomagnesemia or metabolic alkalosis. Genetic analysis revealed compound heterozygous SLC12A3 variants, including a missense mutation and a novel frameshift mutation. This case expands the phenotypic and mutational spectrum of Gitelman syndrome and highlights that it should be considered in pediatric hypokalemia even in the absence of classical biochemical features.

Anahtar Kelimeler

Gitelman syndrome, SLC12A3, hypokalemia

Kaynakça

  1. Simon, D. B., Nelson-Williams, C., Bia, M. J., Ellison, D., Karet, F. E., Molina, A. M., Vaara, I., Iwata, F., Cushner, H. M., Koolen, M., Gainza, F. J., Gitleman, H. J., & Lifton, R. P. (1996). Gitelman’s variant of Bartter’s syndrome, inherited hypokalaemic alkalosis, is caused by mutations in the thiazide-sensitive Na-Cl cotransporter. Nature genetics, 12(1), 24–30. https://doi.org/10.1038/ng0196-24
  2. Gitelman, H. J., Graham, J. B., & Welt, L. G. (1966). A new familial disorder characterized by hypokalemia and hypomagnesemia. Transactions of the Association of American Physicians, 79, 221–235.
  3. Tan, Z., Liu, C., Feng, Z., Luo, Z., Lian, X., & Lu, D. (2025). Gitelman syndrome with hypercalcemia and normomagnesemia: A case report. Medicine, 104(22), e42610. https://doi.org/10.1097/MD.0000000000042610
  4. Blanchard, A., Bockenhauer, D., Bolignano, D., Calò, L. A., Cosyns, E., Devuyst, O., Ellison, D. H., Karet Frankl, F. E., Knoers, N. V., Konrad, M., Lin, S. H., & Vargas-Poussou, R. (2017). Gitelman syndrome: consensus and guidance from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney international, 91(1), 24–33. https://doi.org/10.1016/j.kint.2016.09.046
  5. Knoers, N. V., & Levtchenko, E. N. (2008). Gitelman syndrome. Orphanet journal of rare diseases, 3, 22. https://doi.org/10.1186/1750-1172-3-22
  6. Lin, S. H., Cheng, N. L., Hsu, Y. J., & Halperin, M. L. (2004). Intrafamilial phenotype variability in patients with Gitelman syndrome having the same mutations in their thiazide-sensitive sodium/chloride cotransporter. American journal of kidney diseases : the official journal of the National Kidney Foundation, 43(2), 304–312. https://doi.org/10.1053/j.ajkd.2003.10.018
  7. Janchevska, A., Tasic, V., Jordanova, O., Gucev, Z., Jenkins, L., Jovanovska, N., Plaseska-Karanfilska, D., Ashton, E., & Bockenhauer, D. (2023). Two Brothers from Macedonia with Gitelman Syndrome. Balkan journal of medical genetics : BJMG, 26(1), 69–74. https://doi.org/10.2478/bjmg-2023-0009
  8. Riveira-Munoz, E., Chang, Q., Bindels, R. J., & Devuyst, O. (2007). Gitelman’s syndrome: towards genotype-phenotype correlations?. Pediatric nephrology (Berlin, Germany), 22(3), 326–332. https://doi.org/10.1007/s00467-006-0321-1
  9. Jiang, L., Chen, C., Yuan, T., Qin, Y., Hu, M., Li, X., Xing, X., Lee, X., Nie, M., & Chen, L. (2014). Clinical severity of Gitelman syndrome determined by serum magnesium. American journal of nephrology, 39(4), 357–366. https://doi.org/10.1159/000360773
  10. Walsh, P. R., Tse, Y., Ashton, E., Iancu, D., Jenkins, L., Bienias, M., Kleta, R., Van’t Hoff, W., & Bockenhauer, D. (2018). Clinical and diagnostic features of Bartter and Gitelman syndromes. Clinical kidney journal, 11(3), 302–309. https://doi.org/10.1093/ckj/sfx118

Kaynak Göster

APA
Çeliktaş, D., Girişgen, İ., Durak, T., Becerir, T., & Yuksel, S. (2026). Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum. Pamukkale Medical Journal, 19(4), 874-877. https://doi.org/10.31362/patd.1945983
AMA
1.Çeliktaş D, Girişgen İ, Durak T, Becerir T, Yuksel S. Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum. Pam Tıp Derg. 2026;19(4):874-877. doi:10.31362/patd.1945983
Chicago
Çeliktaş, Deniz, İlknur Girişgen, Taner Durak, Tülay Becerir, ve Selcuk Yuksel. 2026. “Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum”. Pamukkale Medical Journal 19 (4): 874-77. https://doi.org/10.31362/patd.1945983.
EndNote
Çeliktaş D, Girişgen İ, Durak T, Becerir T, Yuksel S (01 Ekim 2026) Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum. Pamukkale Medical Journal 19 4 874–877.
IEEE
[1]D. Çeliktaş, İ. Girişgen, T. Durak, T. Becerir, ve S. Yuksel, “Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum”, Pam Tıp Derg, c. 19, sy 4, ss. 874–877, Eki. 2026, doi: 10.31362/patd.1945983.
ISNAD
Çeliktaş, Deniz - Girişgen, İlknur - Durak, Taner - Becerir, Tülay - Yuksel, Selcuk. “Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum”. Pamukkale Medical Journal 19/4 (01 Ekim 2026): 874-877. https://doi.org/10.31362/patd.1945983.
JAMA
1.Çeliktaş D, Girişgen İ, Durak T, Becerir T, Yuksel S. Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum. Pam Tıp Derg. 2026;19:874–877.
MLA
Çeliktaş, Deniz, vd. “Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum”. Pamukkale Medical Journal, c. 19, sy 4, Ekim 2026, ss. 874-7, doi:10.31362/patd.1945983.
Vancouver
1.Deniz Çeliktaş, İlknur Girişgen, Taner Durak, Tülay Becerir, Selcuk Yuksel. Early-onset Gitelman syndrome with normomagnesemia and absence of metabolic alkalosis: expanding the phenotypic spectrum. Pam Tıp Derg. 01 Ekim 2026;19(4):874-7. doi:10.31362/patd.1945983