We present a patient with Gitelmans syndrome who had marked symptoms of myalgia and lethargy secondary to electrolyte imbalances. Initial management with oral potassium and magnesium replacements failed and she had five to six hospital admissions a month via the emergency department for worsening symptoms and needing i.v. electrolyte replacement. Therefore, she had planned i.v. potassium replacement three times a week via the day unit instead. Although this significantly helped her symptoms and reduced acute admissions, it was very disruptive for her to come to the day unit so frequently.
Therefore a novel way of replacement with i.v. potassium in the community was planned. After discussion and planning with the local team, our patient is now managing her i.v. potassium replacement independently at home. This has not only resulted in marked improvement of her symptoms but also, social independence for her to continue with her daily living. Literature surrounding management of pregnancy in Gitelmans syndrome is limited but our patient had a successful pregnancy and delivered a healthy baby boy using this prescribed regime of replacement.
To our knowledge, this is the first case describing successful management of i.v. potassium replacement in a patient with Gitelmans syndrome done by the patient in their home setting. It also demonstrates the benefit of individualising treatment for such patients with a chronic illness to allow some normality of daily living.