P429 Gitelman Syndrome – Report of the first pediatric patient from Macedonia

Background and aims Gitelman syndrome (GS) is a rare renal channelopathy with an autosomal recessive type of inheritance, caused by homozygous or compound heterozygous mutations in SLC12A3 gene. The disorder causes metabolic abnormalities and may be overlapped with Barter type 3 syndrome. Methods A 7 year-old boy presented with a history of several episodes of carpopedal spasms and muscle aches in the last few months. The boy has been a relatively healthy child previously. His auxological parameters were within normal range for his sex and age. Diagnostic assessment was achieved by characteristic symptoms, imaging technics, biochemical, hormonal and molecular analyses. Results The biochemical analyses revealed hypokalemia (3.0–3.4 mmol/l), hypomagnesemia (0.64–0.66 mmol/l), hypocalciuria ( A pathogenic variants and also heterozygous for the SLC12A3 c.2944 A>T (p.Ile982Phe) likely pathogenic variant. His mother was a heterozygous for the c.2944 A>T (p.Ile982Phe) mutation, but his father was heterozygous for the other 2 variants (SLC12A3 c.1805_1806del and c.2660+1G>A). Conclusions Herein we present a first child from Macedonia with clinical manifestations and electrolyte imbalances typical for a GS. The results of the molecular analyses were consistent with the diagnosis of GS. The boy is on a high salt diet and oral potassium and magnesium supplements.