Significant recovery of nutritional status through individualized dietary management in an adolescent with severe acute malnutrition and suspected Gitelman syndrome: case report
DOI:
https://doi.org/10.29105/respyn24.3-865Keywords:
Terapia Dietética. Tubulopatías. Malnutrición.Abstract
Introduction: Pediatric malnutrition is associated with growth delay and increased morbidity. Likewise, hereditary tubulopathies, often underdiagnosed due to their nonspecific presentation, are frequently accompanied by malnutrition as a relevant manifestation. We present the case of an adolescent with severe acute malnutrition and suspected tubulopathy, in whom individualized dietary intervention led to a significant recovery of nutritional status. Case presentation: A 13-year-old female with a history of intellectual disability and chronic follicular gastritis was admitted due to dehydration, postprandial abdominal pain, early satiety, severe acute malnutrition (body mass index [BMI] 13.5 kg/m², mid-upper arm circumference [MUAC] 18.5 cm), hypokaluria, hypernatriuria, and normal chloruria (suggesting possible diagnosis of Gitelman syndrome). An individualized hypoallergenic diet, rich in potassium and magnesium (2,300 mg and 240 mg), and hypercaloric/hyperproteic (50 kcal/kg and 2 g/kg of protein) was prescribed. After Gitelman syndrome was ruled out, electrolyte supplementation was suspended and the dietary plan was maintained to address malnutrition. After 11 months of follow-up with comprehensive nutritional intervention, the patient achieved a total weight gain of 15.3 kg and a significant recovery of nutritional status. Conclusion: The recovery of nutritional status achieved through individualized dietary intervention highlights the importance of early nutritional management in pediatric patients with suspected tubulopathies. This case underscores the need to strengthen comprehensive diagnostic strategies integrating clinical, biochemical, and genetic analyses to optimize the management and follow-up of malnutrition associated with these conditions.
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Copyright (c) 2025 Adriana Lucía Garza Ramírez, María Alejandra Sánchez Peña , Sofía Cuéllar Robles
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