Deaths Due to Electrolyte Abnormalities and Starvation

We report a rare case of a 32-year-old male who ingested 32.4 to 54 mg of colchicine and presented after 44 hours. He developed progressive multiple organ failure with shock, acute kidney failure, troponemia, pancytopenia, absolute neutropenia, disseminated intravascular coagulation, acute liver failure, rhabdomyolysis, and lactic acidosis. He also developed electrolyte abnormalities and refractory hypoglycemia. Initial treatment consisted of activated charcoal, fluids, and broad-spectrum antibiotics with supportive treatment of mechanical ventilation, hemodialysis, vasopressors, N-acetylcysteine, colony-stimulating factors, and blood products. Literature shows potential benefit of colchicine-specific Fab fragments for acute toxicity with limited studies and is not currently available in the United States. Further research for N-acetylcysteine protocol for acute liver failure in colchicine toxicity and potential use of colchicine-specific Fab fragments is needed. Our case demonstrates the importance of early use of activated charcoal for ingestion overdose with the incorporation of poison control into multidisciplinary team for coordinated patient care.

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Novel Variant in CLDN16: A Further Step in the Diagnosis of Familial Hypomagnesemia with Hypercalciuria and Nephrocalcinosis—A Case Report

Uro ◽

10.3390/uro1030011 ◽

2021 ◽

Vol 1 (3) ◽

pp. 76-81

Author(s):

Gopal Narang ◽

Tim Shimon ◽

Jonathan Moore ◽

Megan Hager ◽

Filippo Pinto e Vairo ◽

...

Keyword(s):

Renal Failure ◽

Clinical Manifestations ◽

Tight Junction Proteins ◽

Early Progression ◽

Significant Burden ◽

Novel Variant ◽

Familial Hypomagnesemia ◽

Calcium And Magnesium ◽

Junction Proteins ◽

Electrolyte Abnormalities

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare tubulopathy characterized by renal loss of calcium and magnesium leading to progressive renal failure. The disorder is caused by variants to the tight junction proteins claudin-16 and -19. While rare, this disorder causes a significant burden to patients based on its clinical manifestations of various electrolyte abnormalities, nephrocalcinosis, and early progression to renal failure. In this report we describe the diagnosis of a novel variant of CLDN16 which clinically presented with severe hypomagnesemia, hypocalcemia, nephrocalcinosis, and renal failure.

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Unusual presentation of pulmonary blastomycosis complicated by amphotericin-induced refractory electrolyte abnormalities

Oxford Medical Case Reports ◽

10.1093/omcr/omaa093 ◽

2020 ◽

Vol 2020 (11) ◽

Author(s):

Pool Tobar ◽

Alejandro Sanchez-Nadales ◽

Elena Caldeira ◽

Peguy Saad

Keyword(s):

Amphotericin B ◽

Liposomal Amphotericin ◽

Pulmonary Infection ◽

Pregnant Patient ◽

Lung Mass ◽

Radiographic Findings ◽

Common Presentation ◽

The Usa ◽

Degrees Of Severity ◽

Electrolyte Abnormalities

ABSTRACT Blastomyces dermatitidis is an endemic mold infection commonly seen in the midwestern of the USA and rarely affects pregnant women. The most common presentation is a pulmonary infection with variable degrees of severity. Of note, the clinical and radiographic findings of pulmonary blastomycosis can be mistaken for other pulmonary pathologies, thus earning the title of ‘the great pretender’. The treatment of choice of infected pregnant patients is amphotericin B, which is known to produce electrolyte imbalances. However, it infrequently causes severe, prolonged and profound hypokalemia and hypomagnesemia. We present the case of a 27-year-old pregnant patient with pulmonary blastomycosis presenting with a lung mass suspicious of malignancy and treated with amphotericin B with subsequent prolonged refractory hypokalemia and hypomagnesemia. Keywords pulmonary blastomycosis pregnancy biopsy computed tomography angiography liposomal amphotericin B

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Electrolyte abnormalities with a fatal implication

Nephrology Dialysis Transplantation ◽

10.1093/ndt/17.10.1849 ◽

2002 ◽

Vol 17 (10) ◽

pp. 1849-1851

Author(s):

P. Carmichael

Keyword(s):

Electrolyte Abnormalities

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Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19)

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/0004563220922255 ◽

2020 ◽

Vol 57 (3) ◽

pp. 262-265 ◽

Cited By ~ 54

Author(s):

Giuseppe Lippi ◽

Andrew M South ◽

Brandon Michael Henry

Keyword(s):

Weighted Mean Difference ◽

Severe Disease ◽

Total Sample ◽

Pooled Analysis ◽

Severe Form ◽

Electrolyte Imbalance ◽

Sodium Potassium ◽

Impact Patient Care ◽

Insight Into ◽

Electrolyte Abnormalities

Background Early studies have reported various electrolyte abnormalities at admission in patients who progress to the severe form of coronavirus disease 2019 (COVID-19). As electrolyte imbalance may not only impact patient care, but provide insight into the pathophysiology of COVID-19, we aimed to analyse all early data reported on electrolytes in COVID-19 patients with and without severe form. Methods An electronic search of Medline (PubMed interface), Scopus and Web of Science was performed for articles comparing electrolytes (sodium, potassium, chloride and calcium) between COVID-19 patients with and without severe disease. A pooled analysis was performed to estimate the weighted mean difference (WMD) with 95% confidence interval. Results Five studies with a total sample size of 1415 COVID-19 patients. Sodium was significantly lower in patients with severe COVID-19 (WMD: –0.91 mmol/L [95% CI: –1.33 to –0.50 mmol/L]). Similarly, potassium was also significantly lower in COVID-19 patients with severe disease (WMD: –0.12 mmol/L [95% CI: –0.18 to –0.07 mmol/L], I2=33%). For chloride, no statistical differences were observed between patients with severe and non-severe COVID-19 (WMD: 0.30 mmol/L [95% CI: –0.41 to 1.01 mmol/L]). For calcium, a statistically significant lower concentration was noted in patients with severe COVID-19 (WMD: –0.20 mmol/L [95% CI: –0.25 to –0.20 mmol/L]). Conclusions This pooled analysis confirms that COVID-19 severity is associated with lower serum concentrations of sodium, potassium and calcium. We recommend electrolytes be measured at initial presentation and serially monitored during hospitalization in order to establish timely and appropriate corrective actions.

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