Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association

Background. Classical salt-wasting (SW) congenital adrenal hyperplasia (CAH) and Gitelman syndrome (GS) are two genetic conditions in which dyselectrolytemia may occur. No association between the two conditions has been previously described. Case Presentation. We present the case of a boy with a neo...

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Main Authors: Valeria Calcaterra, Giulia Roberto, Anna La Rocca, Beatrice Andrenacci, Federico Rossi, Gian Vincenzo Zuccotti, Valentina Fabiano
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2021/6633541
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author Valeria Calcaterra
Giulia Roberto
Anna La Rocca
Beatrice Andrenacci
Federico Rossi
Gian Vincenzo Zuccotti
Valentina Fabiano
author_facet Valeria Calcaterra
Giulia Roberto
Anna La Rocca
Beatrice Andrenacci
Federico Rossi
Gian Vincenzo Zuccotti
Valentina Fabiano
author_sort Valeria Calcaterra
collection DOAJ
description Background. Classical salt-wasting (SW) congenital adrenal hyperplasia (CAH) and Gitelman syndrome (GS) are two genetic conditions in which dyselectrolytemia may occur. No association between the two conditions has been previously described. Case Presentation. We present the case of a boy with a neonatal diagnosis of SW-CAH who showed low potassium blood levels from the age of 15 years. This electrolytic alteration was, at first, attributed to an excessive action of mineralocorticoid drugs. Due to persistence of hypokalemia, SLC12A3 whole genome sequencing was performed, showing a heterozygous C to T base pair substitution at position 965 in gene SLC12A3. This mutation is related to Gitelman syndrome with autosomal recessive transmission. Conclusions. SW-CAH and GS determine opposite values of potassium in the absence of specific therapy, with a natural tendency to compensate each other. The symptom overlap makes diagnosis difficult. Organic causes of hypokalemia in patients undergoing life-saving therapy should not be excluded.
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institution OA Journals
issn 2090-6803
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language English
publishDate 2021-01-01
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series Case Reports in Pediatrics
spelling doaj-art-9b9569379e5a4a8ea5f3d9f8a159e4192025-08-20T02:18:27ZengWileyCase Reports in Pediatrics2090-68032090-68112021-01-01202110.1155/2021/66335416633541Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon AssociationValeria Calcaterra0Giulia Roberto1Anna La Rocca2Beatrice Andrenacci3Federico Rossi4Gian Vincenzo Zuccotti5Valentina Fabiano6Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, ItalyPediatric Unit, Fondazione IRCCS Policlinico S. Matteo and University of Pavia, 27100 Pavia, ItalyPediatric Unit, Fondazione IRCCS Policlinico S. Matteo and University of Pavia, 27100 Pavia, ItalyPediatric Unit, Fondazione IRCCS Policlinico S. Matteo and University of Pavia, 27100 Pavia, ItalyPediatric Unit, Fondazione IRCCS Policlinico S. Matteo and University of Pavia, 27100 Pavia, ItalyDepartment of Pediatrics, Children’s Hospital “V. Buzzi”, 20157 Milano, ItalyDepartment of Pediatrics, Children’s Hospital “V. Buzzi”, 20157 Milano, ItalyBackground. Classical salt-wasting (SW) congenital adrenal hyperplasia (CAH) and Gitelman syndrome (GS) are two genetic conditions in which dyselectrolytemia may occur. No association between the two conditions has been previously described. Case Presentation. We present the case of a boy with a neonatal diagnosis of SW-CAH who showed low potassium blood levels from the age of 15 years. This electrolytic alteration was, at first, attributed to an excessive action of mineralocorticoid drugs. Due to persistence of hypokalemia, SLC12A3 whole genome sequencing was performed, showing a heterozygous C to T base pair substitution at position 965 in gene SLC12A3. This mutation is related to Gitelman syndrome with autosomal recessive transmission. Conclusions. SW-CAH and GS determine opposite values of potassium in the absence of specific therapy, with a natural tendency to compensate each other. The symptom overlap makes diagnosis difficult. Organic causes of hypokalemia in patients undergoing life-saving therapy should not be excluded.http://dx.doi.org/10.1155/2021/6633541
spellingShingle Valeria Calcaterra
Giulia Roberto
Anna La Rocca
Beatrice Andrenacci
Federico Rossi
Gian Vincenzo Zuccotti
Valentina Fabiano
Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
Case Reports in Pediatrics
title Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
title_full Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
title_fullStr Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
title_full_unstemmed Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
title_short Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
title_sort congenital adrenal hyperplasia cah and gitelman syndrome gs overlapping symptoms in an uncommon association
url http://dx.doi.org/10.1155/2021/6633541
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