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Nausea, Emesis, and Muscle Weakness in a Pregnant Adolescent

Srinivas, Sindhu K. MD1; Sukhan, Sabrina MD1; Elovitz, Michal A. MD1

doi: 10.1097/01.AOG.0000168450.72031.d4
Case Report

BACKGROUND: Gitelman syndrome is a rare autosomal recessive disorder that presents in early adulthood with fatigue, muscle cramps and electrolyte abnormalities.

CASE: A 17-year-old African-American woman presented at 17 weeks of pregnancy with nausea, emesis, profound lower extremity proximal muscle weakness, hypokalemia, and hypomagnesemia. After a thorough evaluation, Gitelman syndrome was diagnosed. The patient was maintained on high levels of potassium and magnesium supplementation throughout the rest of her pregnancy and delivered a healthy infant.

CONCLUSION: In pregnancy, nausea and emesis is most commonly attributed to hyperemesis gravidarum. However, an atypical presentation of these symptoms and/or the coexistence of less common complaints warrant further investigation.

Atypical presentation of hyperemesis gravidarum and the coexistence of less common complaints warrant further investigation.

1From the Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.

See related case report on page 486.

Corresponding author: Sindhu K. Srinivas, MD, Department of Obstetrics and Gynecology, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Dulles 573, Philadelphia, PA 19104; e-mail:

© 2006 The American College of Obstetricians and Gynecologists