Abstract: TH-PO0416
Gitelman-Like Syndrome Secondary to Occupational Solvent Inhalation
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Zorrilla Alfaro, Sideré Monserrath, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
- Mora Lojan, Jose Luis, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
- González Flores, Nancy Julieta, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
- Hernández Castillo, José Luis, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
- Diaz Garcia, Juan Daniel, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
- Salinas-Ramirez, Mauricio Adrian, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
- Juarez, Joana Balderas, Hospital General Dr Manuel Gea Gonzalez, Mexico City, CDMX, Mexico
Introduction
Gitelman’s syndrome is a renal tubulopathy characterized by hypokalemic metabolic alkalosis with hypomagnesemia and hypocalciuria, due to distal tubular salt wasting. Symptoms include muscle cramps, paresthesias, nocturia, salt craving, weakness, and fatigue. It is caused by biallelic mutations in the SLC12A3 gene, which encodes the thiazide-sensitive NCC transporter. Non-genetic mimics include diuretic use, chronic laxative abuse, prolonged vomiting, certain medications, autoimmune diseases, and pregnancy but not solvent exposure.
Case Description
A 62-year-old male patient with hypertension and a history of chronic solvent exposure due to his professional roles as a tinsmith and a painter was admitted to the hospital with complaints including upper limb muscle contractions, paresthesias, and bradycardia (57 beats per minute). Laboratory investigations revealed the presence of chlorine-insensitive metabolic alkalosis, renal-origin hypokalemia, hypomagnesemia, hypocalcemia, neutrophilic leukocytosis, and thrombocytosis. Despite exhaustive investigative efforts, no identifiable infectious source was identified. Consequently, CT scans revealed gastric wall thickening. The findings were attributed to solvent inhalation. Following a period of treatment, the patient was discharged on a medication regimen consisting of telmisartan, spironolactone, potassium, magnesium sulfate, and aspirin. The patient demonstrated notable improvement during their follow up.
Discussion
Inhaled solvents can cause various kidney issues, but Gitelman-like syndrome has not been previously reported. This patient had high blood pressure, which is unusual for Gitelman’s syndrome, typically linked to low blood pressure. Elevated white blood cells and platelets were considered reactive. Treatment focused on correcting fluid and electrolyte imbalances, with potassium normalized over 10 days and supplements given. Though genetic testing and renin levels couldn't be measured, the findings indicated a Gitelman-like syndrome caused by solvent inhalation.