A parent and child with Liddle syndrome diagnosed correctly with the child as the proband: a case report with review of literature.
Study Goal
The researchers aimed to diagnose and treat Liddle syndrome (LS), a genetic disorder causing hypertension, and evaluate the effectiveness of ENaC inhibitors and a salt-restricted diet.
Results Summary
The study found that ENaC inhibitors and a salt-restricted diet markedly improved symptoms in patients with LS, leading to better hypertension control. Genetic testing confirmed the diagnosis, facilitating proper treatment.
Population
A 42-year-old male with LS and a 30-year history of hypertension, and his 13-year-old son with similar symptoms.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
ENaC inhibitors and a salt-restricted diet | decrease | symptoms | a 42-year-old male with LS and his son | markedly | improved | #1 |
intensive combination therapy | no change | hypertension | a 42-year-old male with LS | - | poorly controlled | #2 |
early diagnosis and treatment | decrease | complications | patients with LS | - | can prevent | #3 |
Liddle syndrome (LS) is an autosomal dominant genetic disorder characterized by early onset hypertension, hypokalemia, and low plasma aldosterone or renin concentration. It is caused by mutations in subunits of the epithelial sodium channel (ENaC). The clinical phenotypes of LS are variable and nonspecific, making it prone to both misdiagnosis and missed diagnosis. Genetic analysis is necessary to confirm the diagnosis of LS. Herein, we report the case of a 42-year-old male with LS and a 30-year history of hypertension. He was being treated for possible primary aldosteronism (PA) over the preceding 7 years; however, his hypertension was poorly controlled despite intensive combination therapy. His 13-year-old son served as a proband for a diagnosis of LS, as he had hypertension, hypokalemia, and a significant family history of hypertension. Genetic testing revealed a heterozygous pathological variant in the SCNN1B gene. This led to a diagnosis of LS, as the father was found to harbor the same mutation. Both were treated with ENaC inhibitors and a salt-restricted diet, which improved their symptoms markedly. The son's genetic diagnosis facilitated the subsequent proper diagnosis and treatment of his father. LS causes early onset hypertension; hence, its early diagnosis and treatment can prevent complications. Hereditary hypertension should be considered in cases of early onset hypertension with a significant family history. Patients diagnosed with PA using outdated criteria may have concomitant LS and require careful evaluation of biochemical and endocrine tests according to the current criteria.