Progress of diagnosis and treatment for Gitelman syndrome and cystinosis / 中华实用儿科临床杂志

Gitelman syndrome(GS) is an autosomal recessive,salt-losing tubulopathy resulted from inactivating mutations in the SLCl2A3 gene that encodes the Thiazine diuretic sensitive sodium chloride cotransporter (NCCT).GS is characterized by hypokalemic metabolic alkalosis,hypomagnesemia and hypocalciuria.Diagnosis of GS is relied on the clinical symptoms,biochemical abnormalities and genetic test.All GS patients are suggested to keep high-sodium diet.Magnesium and potassium supplements are usually given to GS patients for lifelong to improve clinical symptoms.Individual management of GS includes health education,complication evaluation and regular follow-up with annual evaluation by a nephrologist.Cystinosis is a rare autosomal-recessive lysosomal storage disease caused by inactivating mutations in the CTNS gene that encodes the lysosomal cystine transporter,cystinosin,resulting in the accumulation of cystine within the lysosome.There are 3 clinical forms of cystinosis:infantile or early-onset nephropathic cystinosis,juvenile or late-onset nephropathic cystinosis and adult or ocular cystinosis.Diagnosis of cystinosis is based on the CTNS genetic test.Early diagnosis and early cystine-depleting therapy with cysteamine is essential to prevent or attenuate end-organ damage and improve overall prognosis.

Clinical characteristics and gene analysis in three children with Gitelman syndrome / 临床儿科杂志

Objectives To explore the clinical and gene mutation characteristics of Gitelman syndrome in children. Method The clinical data of 3 children with Gitelman syndrome were retrospectively analyzed. Results All three cases were male and their age were 3, 8 and 10 years . The clinical manifestations were hypokalemia, hypomagnesemia, alkalosis, hyperreninemia,and hyperaldosteronemia.Gene detection revealed a complex heterozygous mutation in the SLC12A3 gene.A total of 5 mutation sites were found in the SLC12A3 gene,c.179C>T(Thr60Met),c.248 G>A(Arg83Gln),c.2129 C>A(Ser710X), c.2660+1G>A, c.1456G>A (Asp486Asn). After the diagnosis was confirmed, they were treated with potassium supplement, magnesium supplement, and spironolactone and the conditions were improved in all cases. Conclusions In children with hypokalemia, be aware of Gitelman syndrome, and gene detection is helpful for the diagnosis.