Background: In cases of normotensive patients, hypokalemia with metabolic alkalosis is most frequently caused by repeated vomiting or diuretics abuse, and rarely by tubulopathies, e.g., Bartter or Gitelman syndrome (GS). Case report: An adolescent girl who was repeatedly examined due to collapses and cramps in the hands. A characteristic set of metabolic abnormalities for tubulopathies was discovered in an acute stress situation with inapetence. Proper diet and supplementation with potassium and magnesium was needed for maintaining electrolyte balance of the patient. Conclusions: In cases of unexplained hypokalemia and metabolic alkalosis associated with a normal or low blood pressure a tubulopathy, e.g., Gitelman syndrome, must be excluded. The identification and recognition of correct diagnosis is extremely important since a proper treatment can reduce the risk of life-threatening events, e.g. arrhythmias.