Background. Gitelman's syndrome (GS), also called Gitelman's variant of Bar
tter's syndrome, is an autosomal recessive renal disorder characterized by
hypokalemia, hypomagnesemia. metabolic alkalosis, and hypocalciuria. GS is
caused by inactivating mutations in the thiazide-sensitive sodium chloride
cotransporter gene (NCCT). It is also known as the "milder" form of Bartter
's syndrome, as patients with GS are usually diagnosed in adulthood during
routine investigation. Symptoms reported in the literature range from asymp
tomatic, to mild symptoms of cramps and fatigue, to severe manifestations s
uch as tetany, paralysis. and rhabdomyolysis. This is the first systematic
evaluation of a large group of patients with genetically defined GS.
Methods. We evaluated the symptoms and quality of life (QOL) in 50 adult GS
patients with confirmed mutations in NCCT. using a standardized questionna
ire. This cohort was compared with 25 age- and sex-matched controls.
Results. GS patients were significantly more symptomatic than controls. The
most common symptoms were salt craving, with musculoskeletal symptoms such
as cramps, muscle weakness, and aches and constitutional symptoms such as
fatigue. generalized weakness and dizziness, and nocturia and polydipsia. F
orty-five percent of GS patients consider their symptoms a moderate to big
problem. Measures of health-related QOL were significantly lower in GS pati
ents compared with controls, particularly in terms of role limitations caus
ed by physical health. emotion. level of energy, and general health percept
ion.
Conclusions. This descriptive study indicates that GS is not an asymptomati
c disease and adversely affects QOL in these patients. Further studies are
needed to assess the impact of therapy on symptoms and QOL.