Quadriparesis due to Gitelman′s syndrome diagnosed with thiazide diuretic test response

Abstract

Gitelman′s syndrome is characterized by hypocalciuria, severe hypomagnesemia, and prominent muscular involvements such as fatigue, weakness, cramps, and tetany. It is due to mutations in the thiazide sensitive NaCl co-transporter in the distal convoluted tubule. The administration of thiazide diuretics may induce a subnormal increase of urinary Cl− excretion in patients with Gitelman′s syndrome, consistent with the hypothesis that less than normal Cl− is reabsorbed by the thiazide-inhibitable transporter in Gitelman′s syndrome. Thus, we report a case of Gitelman′s syndrome presenting with quadriparesis diagnosed by using thiazide clearance test.