**Martina Tetti 1, Silvia Monticone 1, Jacopo Burrello 1, Patrizia Matarazzo 2, Franco Veglio 1, Barbara Pasini 3, Xavier Jeunemaitre 4,5,6 and Paolo Mulatero 1,\***


Received: 31 January 2018; Accepted: 7 March 2018; Published: 11 March 2018

**Abstract:** Liddle syndrome is an inherited form of low-renin hypertension, transmitted with an autosomal dominant pattern. The molecular basis of Liddle syndrome resides in germline mutations of the *SCNN1A*, *SCNN1B* and *SCNN1G* genes, encoding the α, β, and γ-subunits of the epithelial Na+ channel (ENaC), respectively. To date, 31 different causative mutations have been reported in 72 families from four continents. The majority of the substitutions cause an increased expression of the channel at the distal nephron apical membrane, with subsequent enhanced renal sodium reabsorption. The most common clinical presentation of the disease is early onset hypertension, hypokalemia, metabolic alkalosis, suppressed plasma renin activity and low plasma aldosterone. Consequently, treatment of Liddle syndrome is based on the administration of ENaC blockers, amiloride and triamterene. Herein, we discuss the genetic basis, clinical presentation, diagnosis and treatment of Liddle syndrome. Finally, we report a new case in an Italian family, caused by a *SCNN1B* p.Pro618Leu substitution.

**Keywords:** hypertension; hypokalemia; low renin hypertension; monogenic hypertension; Liddle syndrome; *SCNN1A*; *SCNN1B*; *SCNN1G*
