Work

Resolution of Hypokalemia and Hypotension With Tacrolimus and Extrarenal Transplantation in Gitelman Syndrome

Year: 2025

Type: article

Abstract: Gitelman syndrome (GS) is characterized by genetic mutations in the sodium chloride cotransporter (NCC), leading to renal potassium, sodium, and magnesium wasting. Calcineurin inhibitors recapitulate familial hyperkalemic hypertension, with gain of function of the NCC. Whether calcineurin inhibition can overcome fluid/electrolyte dyscrasias in GS is unknown. We describe a patient with GS initiated on tacrolimus, a calcineurin phosphatase inhibitor, after orthotopic heart transplantation. Potassium supplementation and potassium-sparing diuretics were discontinued with no consequential hypokalemia, and hypotension and hypomagnesemia also improved. This case provides proof of concept that calcineurin inhibitors may help overcome clinical sequelae of loss of function of NCC in GS.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2025.0570

Authors: Halee Yue, Martina Cacciapuoti, Jennefer Carter, Vivek Bhalla

Institutions: Stanford Medicine, Stanford University, University of Padua, Azienda Ospedale - Università Padova

Language: English

Topic: Potassium and Related Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416929224

FWCI:

Cites: 15

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