Depressive State and Paresthesia Dramatically Improved by Intravenous MgSO4 in Gitelman’s Syndrome

• Published in: Internal Medicine Vol. 43; no. 5; pp. 410 - 414
• Main Authors: ENYA, Mayumi, KANOH, Yoshinori, MUNE, Tomoatsu, ISHIZAWA, Masayoshi, SARUI, Hiroshi, YAMAMOTO, Mayumi, TAKEDA, Noriyuki, YASUDA, Keigo, YASUJIMA, Minoru, TSUTAYA, Shoji, TAKEDA, Jun
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.05.2004; Japanese Society of Internal Medicine
• Subjects: Aged; Alkalosis - diagnosis; Bartter Syndrome - diagnosis; Biological and medical sciences; Depressive Disorder - diagnosis; Depressive Disorder - drug therapy; depressive state; Female; Follow-Up Studies; gene testing; General aspects; Humans; Hyperaldosteronism - diagnosis; Hypocalcemia - diagnosis; hypokalemia; Hypokalemia - diagnosis; hypomagnesemia; Infusions, Intravenous; Magnesium Deficiency - diagnosis; Magnesium Deficiency - prevention & control; Magnesium Sulfate - administration & dosage; Medical sciences; mutation; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Paresthesia - diagnosis; Paresthesia - drug therapy; Risk Assessment; Syndrome; Treatment Outcome; Tubulopathies; Kidney disease; Gitelman syndrome; Sensitivity disorder; Nervous system diseases; Urinary system disease; Intravenous administration; Tubulopathy; Paresthesia; Genetic disease; Medicine; mutation; hypokalemia; depressive state; hypomagnesemia; gene testing; Neurological disorder
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.43.410

A 69-year-old woman was referred to our department for evaluation of hypokalemia, which had been treated by oral potassium for more than ten years. She complained of headache, knee joint pain, sleeplessness and paresthesia in extremities and, most prominently, depression. Laboratory data suggested Gitelman’s syndrome, which is caused by mutations in the gene encoding the thiazide-sensitive Na-Cl cotransporter. Direct sequencing of the gene in this patient revealed homozygous mutation R964Q in exon 25. Intravenous supplement of MgSO4 dramatically improved both the depression and the paresthesia, suggesting that hypomagnesemia played a role in the clinical manifestations.