Patient with Bartter syndrome in whom chronic potassium depletion was considered one of the causes of hyponatremia

2021 ◽  
Vol 14 (3) ◽  
pp. e240898
Author(s):  
Katsunobu Yoshioka
Keyword(s):  
Potassium Concentration ◽  
Sodium Concentration ◽  
Bartter Syndrome ◽  
Potassium Depletion ◽  
C Reactive Protein ◽  
Laboratory Examination ◽  
Serum Potassium Concentration ◽  
Reactive Protein ◽  
General Fatigue ◽  
Electrolyte Replacement

A 53-year-old man was admitted to our hospital because of general fatigue and disorientation. He had been diagnosed with Bartter syndrome in his teens and had been taking potassium preparations since then. However, his serum potassium concentration (K+s) remained persistently low. Ten days before admission, he developed fever. He was diagnosed as having bronchitis and was treated with antibiotics. Although his fever subsided, general fatigue worsened. Laboratory examination showed hyponatraemia (127 mEq/L), while K+s was 2.3 mEq/L. C reactive protein was negative. On admission, laboratory examination revealed deterioration of hyponatraemia (125 mEq/L). Although his serum sodium concentration (Na+s) was refractory to electrolyte replacement, the level increased towards normal after spironolactone administration, following normalisation of K+s, suggesting that hyponatraemia was caused by K+ depletion. Physicians should be aware of the importance of the effects of exchangeable K+ (K+e) on Na+s.

scholarly journals Correcting hypokalaemia in a paediatric patient with Bartter syndrome through oral dose of potassium chloride intravenous solution

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110197
Author(s):  
Salman Alasfour ◽  
Haya S Alfailakawi ◽  
Yousif A Shamsaldeen
Keyword(s):  
Paediatric Patient ◽  
Potassium Chloride ◽  
Serum Potassium ◽  
Nasogastric Tube ◽  
Potassium Concentration ◽  
Oral Route ◽  
Bartter Syndrome ◽  
Intravenous Route ◽  
Serum Potassium Concentration ◽  
Main Challenge

Bartter syndrome is a rare autosomal recessive disorder characterized by hypokalaemia. Hypokalaemia is defined as low serum potassium concentration ˂3.5 mmol/L, which may lead to arrhythmia and death if left untreated. The aim of this case report was to normalize serum potassium concentration without the need for intravenous intervention. A 5-month-old male of 2.7 kg body weight diagnosed with Bartter syndrome was admitted to the general paediatric ward with acute severe hypokalaemia and urinary tract infection. The main challenge was the inability to administer drugs through intravenous route due to compromised body size. Therefore, we shifted the route of administration to the nasogastric tube/oral route. A total of 2 mL of concentrated intravenous potassium chloride (4 mEq potassium) were dissolved in distilled water and administered through nasogastric tube. Serum potassium concentration was rapidly normalized, which culminated in patient discharge. In conclusion, shifting drug administration from intravenous to oral route in a paediatric patient with Bartter syndrome includes numerous advantages such as patient convenience, minimized risk of cannula-induced infection, and reduced nurse workload.

scholarly journals Emphysematous Cystitis Occurred in the Case Treated with Steroid for Autoimmune Hepatitis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Tateki Yoshino ◽  
Shinya Ohara ◽  
Hiroyuki Moriyama
Keyword(s):  
Blood Culture ◽  
Autoimmune Hepatitis ◽  
Complete Blood Count ◽  
Bladder Wall ◽  
Foley Catheter ◽  
C Reactive Protein ◽  
Laboratory Examination ◽  
Emphysematous Cystitis ◽  
Reactive Protein ◽  
Wbc Count

Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients, which was characterized by air within the bladder wall and lumen. A 83-year-old woman was introduced to our department with fever elevation and abnormal findings of computed tomography (CT). She took orally prednisolone for autoimmune hepatitis. Pelvic CT revealed diffuse air throughout the bladder wall. Urinalysis showed combined hematuria and pyuria.Escherichia coliwas detected in blood culture. Abnormal findings of complete blood count and laboratory examination included an elevated WBC count (12,200/L), C-reactive protein (11.7 mg/dL), and creatinine (1.07 mg/dL). Cystoscopy confirmed diffuse submucosal emphysema throughout. On the basis of diagnosis with emphysematous cystitis, she was treated with antibiotics based on the results of blood culture and indwelling Foley catheter. After treatment, the improvement of inflammatory findings and submucosal emphysema on cystoscopy and CT were achieved.

Clinical characteristics of COVID-19 patients (Latvia, Spring 2020)

2020 ◽  
Author(s):  
Ludmila Viksna ◽  
◽  
Oksana Kolesova ◽  
Aleksandrs Kolesovs ◽  
Ieva Vanaga ◽  
...  
Keyword(s):  
Blood Cells ◽  
Troponin T ◽  
Sodium Concentration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Coagulation Tests ◽  
Damage Indicators ◽  
Prothrombin Index ◽  
D Dimer

Data include following variables: Demographics, epidemiological history, comorbidities, diagnosis, complications, and symptoms on admission to the hospital. Also, body’s temperature and SpO2. Blood cells: white cells count (WBC), neutrophils (Neu), lymphocytes (Ly), eosinophils (Eo) and monocytes (Mo), percentages of segmented and banded neutrophils, erythrocytes (RBC), platelet count (PLT), hemoglobin (Hb), and hematocrit (HCT); Inflammatory indicators: erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); Tissue damage indicators: alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and troponin T (TnT); Electrolytes: potassium and sodium concentration; Renal function indicators: creatinine and glomerular filtration rate (GFR); Coagulation tests: D-dimer, prothrombin time, and prothrombin index on admission to the hospital.

Subcutaneous administration of desoxycorticosterone pivalate for the treatment of canine hypoadrenocorticism

1995 ◽  
Vol 31 (2) ◽  
pp. 151-155 ◽  
Author(s):  
MD McCabe ◽  
EC Feldman ◽  
RC Lynn ◽  
PH Kass
Keyword(s):  
Body Weight ◽  
Potassium Concentration ◽  
Subcutaneous Administration ◽  
Sodium Concentration ◽  
Serum Electrolyte ◽  
Serum Electrolytes ◽  
Serum Potassium Concentration ◽  
Median Serum ◽  
Previously Treated ◽  
Fludrocortisone Acetate

Twelve dogs with hypoadrenocorticism were treated with subcutaneous desoxycorticosterone pivalate (DOCP). Eight of these dogs were recently diagnosed and had not yet been treated. Four dogs previously had been diagnosed and treated (three with intramuscular DOCP, one with oral fludrocortisone acetate). History, physical examination, serum electrolytes, and blood urea nitrogen (BUN) were evaluated. Desoxycorticosterone pivalate (2.2 mg/kg body weight) was administered every 25 days. On day 0, recently diagnosed dogs had a median serum sodium concentration of 131.5 mEq/L, median serum potassium concentration of 6.6 mEq/L, and median BUN of 41.5 mg/dl. All subsequent median serum electrolyte and BUN concentrations were normal. All previously treated dogs had normal blood values which were maintained throughout the study.

PLASMA ALDOSTERONE CONCENTRATION IN ANEPHRIC CHILDREN

1974 ◽  
Vol 75 (3) ◽  
pp. 561-568 ◽  
Author(s):  
M. Birkhäuser ◽  
C. Godard ◽  
C. Loirat ◽  
M. B. Vallotton
Keyword(s):  
Serum Sodium ◽  
Plasma Cortisol ◽  
Potassium Concentration ◽  
Extracellular Volume ◽  
Sodium Concentration ◽  
Plasma Aldosterone ◽  
Volume Depletion ◽  
Plasma Aldosterone Concentration ◽  
Serum Potassium Concentration ◽  
Postural Changes

ABSTRACT The effect of extractive haemodialysis and of postural changes on the plasma aldosterone concentration has been studied in 5 anephric children. The plasma aldosterone concentration tended to be lower after haemodialysis in spite of the extracellular volume depletion induced. No regular response occurred after orthostatism. There was no correlation between the plasma aldosterone and the plasma cortisol or the serum sodium concentration. A weak positive correlation was found between the plasma aldosterone and serum potassium concentration, suggesting that potassium may play a major role in aldosterone regulation in the anephric state.

Does a Reduction in Serum Sodium Concentration or Serum Potassium Concentration Increase the Prevalence of Exercise-Associated Muscle Cramps?

2016 ◽  
Vol 25 (3) ◽  
pp. 301-304 ◽  
Author(s):  
Donal Murray ◽  
Kevin C. Miller ◽  
Jeffrey E. Edwards
Keyword(s):  
Serum Sodium ◽  
Serum Potassium ◽  
Potassium Concentration ◽  
Sodium Concentration ◽  
Serum Sodium Concentration ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Muscle Cramps ◽  
Serum Potassium Concentration ◽  
Exercise Associated Muscle Cramps

Clinical Scenario:Although exercise-associated muscle cramps (EAMC) are common in ultradistance runners and athletes in general, their etiology remains unclear. EAMC are painful, sudden, involuntary contractions of skeletal muscle occurring during or after exercise and are recognized by visible bulging or knotting of the whole, or part of, a muscle. Many clinicians believe EAMC occur after an imbalance in electrolyte concentrations, specifically serum sodium concentration ([Na+]s) and serum potassium concentration ([K+]s). Studies that have established a link between EAMC occurrence and serum electrolyte concentrations after an athletic event are unhelpful.Focused Clinical Question:Are [Na+]s and [K+]s different in athletes who experience EAMC than noncrampers?

scholarly journals ASSOCIATION BETWEEN SEPSIS RISK CALCULATOR AND INFECTION PARAMETERS FOR NEONATES WITH RISK OF EARLY ONSET SEPSIS

2020 ◽  
Vol 8 (2) ◽  
pp. 108
Author(s):  
Trias Kusuma Sari ◽  
Irwanto Irwanto ◽  
Risa Etika ◽  
Mahendra Tri Arif Sampurna ◽  
Ni Made Mertaniasih
Keyword(s):  
Acute Phase ◽  
Early Onset ◽  
P Value ◽  
Risk Calculator ◽  
C Reactive Protein ◽  
Laboratory Examination ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Sepsis Risk ◽  
Infection Parameters

C-reactive protein (CRP) is an acute-phase reactant protein that is primarily induced by the IL-6 action during the acute phase of an inflammatory or infectious process. Bacterial infection is a potent stimulus, leading to a rapid elevation of CRP levels within hours while the CBC and symptom are often misleading and/or absent. American Academy of paediatrics (AAP) is recommended routine blood examination test Complete Blood Count (CBC), C-reactive protein (CRP), and blood culture along with empirical antibiotic in neonates with early onset sepsis risk (EOS) risk even asymptomatic. Previous study is showed there were no correlation of CRP and EOS risk. The aim of this study is to evaluate the CRP and CBC profile in neonate with risk of EOS.  Methods of this study is using the sepsis risk calculator (SRC) to calculate the probability of neonatal early onset sepsis (EOS) based on maternal risk and infant’s clinical presentation. Neonates with ≥34 weeks of gestation who were started on antibiotic treatment after laboratory examination and blo odculture were taken. EOS risk estimation were compared including CRP, leukocyte, and thrombocyte count. ANOVA applied to distinguished laboratory examination between stratified risk groups. The result is showed using 82 subjects who met the inclusion and exclusion criterias, EOS risk level was stratified into green, yellow, and red group. The p value of CRP level, platelets, white blood cell were 0.35,0.54 and 0.48 where p value was considered as significant if < 0.5. The conclusion of this study is there were no correlation of CRP level and EOS riskASSOCIATION BETWEEN SEPSIS RISK CALCULATOR AND INFECTION PARAMETERS FOR NEONATES WITH RISK OF EARLY ONSET SEPSIS

CHANGES IN PLASMA RENIN ACTIVITY AND PLASMA ALDOSTERONE IN THE INDUCED PARALYTIC ATTACK OF THYROTOXIC PERIODIC PARALYSIS

1976 ◽  
Vol 82 (3) ◽  
pp. 715-727 ◽  
Author(s):  
Ryoyu Takeda ◽  
Shinpei Morimoto ◽  
Kenzo Uchida ◽  
Isamu Miyamori
Keyword(s):  
Plasma Renin Activity ◽  
Serum Sodium ◽  
Serum Potassium ◽  
Potassium Concentration ◽  
Plasma Renin ◽  
Sodium Concentration ◽  
Plasma Aldosterone ◽  
Renin Activity ◽  
Serum Sodium Concentration ◽  
Serum Potassium Concentration

ABSTRACT Changes in serum electrolytes, haematocrit, plasma renin activity and plasma aldosterone induced by glucose and insulin (GI) infusion were serially investigated in seven patients with periodic thyrotoxic paralysis. An attack which developed into complete quadriplegia was induced within 90 min after the beginning of the GI infusion in four out of seven patients. Only a slight paralysis of the legs was produced in another two patients and induction of an attack did not materialize in one. In four patients with complete quadriplegia, the mean values of serum sodium and potassium concentrations, haematocrit, plasma renin activity and plasma aldosterone slightly decreased immediately after the beginning of the GI infusion. Induction of a paralytic attack was not accompanied by any significant changes in serum sodium concentration, haematocrit, plasma renin activity and plasma aldosterone either 15 min before or after the onset of attack, while the serum potassium concentration progressively decreased, and an increase in plasma aldosterone associated with an increase of haematocrit and plasma renin activity reached a peak level at the stage of complete quadriplegia. On the other hand, in the three patients in whom an infusion produced slight or no paralysis of the legs, changes in the serum sodium concentration, haematocrit, plasma renin activity and plasma aldosterone were insignificant and the serum potassium concentration was slightly but insignificantly decreased. These results suggest that hyperaldosteronism may not be a trigger for the induced paralytic attack but a phenomenon secondary to volume depletion and a change in potassium homoeostasis induced by GI infusion.

ARTERIAL HYPERTENSION INDUCED BY 9α-FLUOROCORTISOL IN RATS

1974 ◽  
Vol 75 (3) ◽  
pp. 539-549 ◽  
Author(s):  
R. Hepp ◽  
K. Garbade ◽  
P. Oster ◽  
F. Gross
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Intramuscular Injection ◽  
Potassium Concentration ◽  
Sodium Concentration ◽  
List Type ◽  
Serum Potassium Concentration ◽  
High Doses ◽  
Renin Content ◽  
Drinking Fluid

ABSTRACT In unilaterally nephrectomized rats, 9α-fluorocortisol (9α-FF), in doses of 0.3 and 1.0 mg given daily by intramuscular injection, induced an increase in blood pressure that was independent of additional sodium supply. 9α-FF reduced weight gain and, in the dose of 1.0 mg, increased fluid turnover when 0.9 % saline was given to drink. Haematocrit values were elevated, whether saline or water was given as drinking fluid. The serum sodium concentration was increased when saline was offered, but normal with water as drinking fluid. The serum potassium concentration was diminished in all groups that received 9α-FF. The renin content of the kidney was markedly depressed in all groups that had 9α-FF. The degree of suppression was similar in the groups that had saline and those that had water to drink. Under 9α-FF, plasma concentration of angiotensin II was virtually zero when saline was given to drink, but about ¼ to ½ normal when drinking fluid was water. It is concluded that the type of hypertension developing under high doses of 9α-FF resembles glucocorticoid rather than mineralocorticoid hypertension.

scholarly journals DIAGNOSIS OF COLORECTAL ANASTOMOSIS FAILURE (review of foreign literature)

2018 ◽  
Vol 17 (3) ◽  
pp. 81-87
Author(s):  
R. V. Senyutovych ◽  
O. I. Ivashchuk ◽  
V. Yu. Bodyaka ◽  
Yu. Ya. Chuprovsʹka
Keyword(s):  
Prognostic Value ◽  
Colorectal Anastomosis ◽  
Contrast Enema ◽  
C Reactive Protein ◽  
Laboratory Examination ◽  
Drainage Fluid ◽  
Reactive Protein ◽  
Cardiac Symptoms ◽  
Radiological Methods ◽  
Endoscopic Methods

The data about leaks of colorectal anastomosis is presented. Analysis of 25 articles is presented. Method of diagnostics of this complication is computed tomography after contrast enema. Specificity of this method is more than 90%. Endoscopic methods of visualization of leaks were not found to be reasonable. Laboratory examination of drainage exudates is advisable. Different cardiac symptoms appear in 40% of patients. The level of prognostic value is not high; the surgeons predict the possibility of the leaks- sensitivity 62%, specificity – 52%. The analysis of some biological substances in drainage fluid - interleukin, C reactive protein, necrosis tumor factor is indicated. Contrast radiological methods have sensitivity 94-100%. Intraoperative tests with methylene blue are useful for indication to repair anastomosis during operation. Intraoperative colonoscopy is in process of investigation.

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