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Gitelman syndrome is a rare renal tubule disease characterized by hypokalaemia, metabolic alkalosis, hypomagnesaemia, hypocalciuria and normal blood pressure. It shows autosomal recessive inheritance and is usually not diagnosed until late childhood or adulthood. We report the case of 34-year-old woman who at 21 weeks of pregnancy was admitted to the gynaecology department for abdominal pain, muscle cramps and weakness. Routine blood tests showed hypokalaemia (2.32 mEq/l), hypomagnesaemia (1.18 mEq/l), compensated metabolic alkalosis (pH 7.439, bicarbonate 26.1 mmol/l), increased urinary magnesium excretion (140.25 mg/day, normal range 73–122 mg/day) and reduced urinary calcium excretion (49.25 mg/day, normal range 100–250 mg/day). In light of these findings, the patient was diagnosed with Gitelman syndrome and optimum potassium and magnesium levels were maintained with oral supplements. LEARNING POINTS Gitelman syndrome is a rare genetic disease which can affect women of childbearing age. There is no evidence-based treatment algorithm for treating pregnant patients with Gitelman syndrome. Electrolyte disturbances and their treatment in pregnant patients can be challenging since many drugs have limited safety data.

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Background: Heart failure (HF) is a common disease which is one of the most common causes of hospitalization. Although mortality rates are decreasing, readmission rates are still quite high. Objectives: We aimed to investigate the risk factors for readmission and death in patients who were hospitalized due to HF. Design and Setting: Retrospective study, Hacettepe University, Ankara, Turkey Methods: Patients hospitalized between 1 January 2014 to 31 December 2018 with the primary diagnosis of HF were included. Outcome variables were risk factors for 30-day all- caused readmission, 30-day HF related readmission, mortality. Results: All-cause 30-day readmission rate was 34.8% and HF-related 30-day readmission rate was 21.2%. The factors associated with increased all-caused 30-day readmission were male gender, hyperlipidemia, chronic liver disease, malignancy. The factors associated with increased HF-related 30-day readmission were hyperlipidemia, chronic liver disease, inflammatory rheumatologic diseases, malignancy. Use of ACE-i was found to be protective against all-cause and HF-related 30-day readmission. Factors associated with mortality were ejection fraction <30%, chronic liver disease, acute kidney injury, hypoalbuminemia at the time of admission. Conclusions: Nearly one third of patients in this cohort who were hospitalized with a primary diagnosis of HF were readmitted in the following 30 days. Having certain chronic diseases and conditions were associated with an increased risk for readmission and mortality. These findings point out to the special needs of HF patients, who require a proactive, integrated and multidisciplinary management strategy to control the risk factors and to improve the inpatient and transitional stages in the hospital.