Reactions 1459 - 6 Jul 2013 Potassium chloride/spironolactone Gastrointestinal complaints and gynaecomastia in an elderly patient: case report A 79-year-old man with Gitelman syndrome developed gastrointestinal (GI) complaints while receiving potassium chloride and gynaecomastia while receiving spironolactone. The man had been started on oral potassium chloride 4800mg [frequency not stated] 4 years previously, due to low potassium levels. He was subsequently diagnosed with Gitelman syndrome, confirmed by sequence analysis of the SLC12A3 gene showing the presence of the heterozygous mutation Gly439Ser and Arg1018Term. Despite treatment, his hypokalaemia persisted. As higher doses of potassium chloride caused GI complaints, the man was given additional magnesium and spironolactone 200mg [route and frequency not stated]. However, after 1 month, painful gynaecomastia developed. Spironolactone was changed to aliskiren, and he totally recovered within 3 weeks. His serum potassium level rose and was maintained within the normal range with aliskiren and oral potassium chloride 3600mg. The fractional excretion of potassium fell to 22.7%. Author comment: "Normalization of serum potassium was not achieved, since higher doses of potassium chloride caused gastrointestinal complaints. . . painful gynecomastia occurred, and spironolactone was switched to aliskiren". Brambilla G, et al. It is never too late for a genetic disease: A case of a 79-year- old man with persistent hypokalemia. Journal of Nephrology 26: 594-598, No. 3, Jun 2013. Available from: URL: http://dx.doi.org/10.5301/jn.5000256 - Italy 803089548 1 Reactions 6 Jul 2013 No. 1459 0114-9954/10/1459-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Potassium chloride/spironolactone

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Reactions 1459 - 6 Jul 2013

Potassium chloride/spironolactone

Gastrointestinal complaints and gynaecomastia inan elderly patient: case report

A 79-year-old man with Gitelman syndrome developedgastrointestinal (GI) complaints while receiving potassiumchloride and gynaecomastia while receiving spironolactone.

The man had been started on oral potassium chloride4800mg [frequency not stated] 4 years previously, due to lowpotassium levels. He was subsequently diagnosed withGitelman syndrome, confirmed by sequence analysis of theSLC12A3 gene showing the presence of the heterozygousmutation Gly439Ser and Arg1018Term. Despite treatment, hishypokalaemia persisted.

As higher doses of potassium chloride caused GIcomplaints, the man was given additional magnesium andspironolactone 200mg [route and frequency not stated].However, after 1 month, painful gynaecomastia developed.Spironolactone was changed to aliskiren, and he totallyrecovered within 3 weeks. His serum potassium level rose andwas maintained within the normal range with aliskiren and oralpotassium chloride 3600mg. The fractional excretion ofpotassium fell to 22.7%.

Author comment: "Normalization of serum potassiumwas not achieved, since higher doses of potassium chloridecaused gastrointestinal complaints. . . painful gynecomastiaoccurred, and spironolactone was switched to aliskiren".Brambilla G, et al. It is never too late for a genetic disease: A case of a 79-year-old man with persistent hypokalemia. Journal of Nephrology 26: 594-598, No. 3,Jun 2013. Available from: URL: http://dx.doi.org/10.5301/jn.5000256 -Italy 803089548