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

Mayumi ENYA; Yoshinori KANOH; Tomoatsu MUNE; Masayoshi ISHIZAWA; Hiroshi SARUI; Mayumi YAMAMOTO; Noriyuki TAKEDA; Keigo YASUDA; Minoru YASUJIMA; Shoji TSUTAYA; Jun TAKEDA

doi:10.2169/internalmedicine.43.410

Renal Diseases

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

Mayumi ENYA, Yoshinori KANOH, Tomoatsu MUNE, Masayoshi ISHIZAWA, Hiroshi SARUI, Mayumi YAMAMOTO, Noriyuki TAKEDA, Keigo YASUDA, Minoru YASUJIMA, Shoji TSUTAYA, Jun TAKEDA

Author information

Mayumi ENYA
Third Department of Internal Medicine, Gifu University School of Medicine
Yoshinori KANOH
Third Department of Internal Medicine, Gifu University School of Medicine
Tomoatsu MUNE
Third Department of Internal Medicine, Gifu University School of Medicine
Masayoshi ISHIZAWA
Third Department of Internal Medicine, Gifu University School of Medicine
Hiroshi SARUI
Third Department of Internal Medicine, Gifu University School of Medicine
Mayumi YAMAMOTO
Third Department of Internal Medicine, Gifu University School of Medicine
Noriyuki TAKEDA
Third Department of Internal Medicine, Gifu University School of Medicine
Keigo YASUDA
Center for Lifestyle-Related Diseases, Matsunami General Hospital
Minoru YASUJIMA
Department of Laboratory Medicine, Hirosaki University School of Medicine
Shoji TSUTAYA
Department of Laboratory Medicine, Hirosaki University School of Medicine
Jun TAKEDA
Third Department of Internal Medicine, Gifu University School of Medicine
Laboratory of Molecular Genetics, Department of Cell Biology, Institute for Molecular and Cellular Regulation, Gunma University

Keywords: hypokalemia, hypomagnesemia, depressive state, gene testing, mutation

JOURNAL OPEN ACCESS

2004 Volume 43 Issue 5 Pages 410-414

DOI https://doi.org/10.2169/internalmedicine.43.410

Details

Abstract

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.

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