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Hypokalemia

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https://www.readbyqxmd.com/read/27926853/a-dynamical-threshold-for-cardiac-delayed-afterdepolarization-mediated-triggered-activity
#1
Michael B Liu, Christopher Y Ko, Zhen Song, Alan Garfinkel, James N Weiss, Zhilin Qu
Ventricular myocytes are excitable cells whose voltage threshold for action potential (AP) excitation is ∼-60 mV at which INa is activated to give rise to a fast upstroke. Therefore, for a short stimulus pulse to elicit an AP, a stronger stimulus is needed if the resting potential lies further away from the INa threshold, such as in hypokalemia. However, for an AP elicited by a long duration stimulus or a diastolic spontaneous calcium release, we observed that the stimulus needed was lower in hypokalemia than in normokalemia in both computer simulations and experiments of rabbit ventricular myocytes...
December 6, 2016: Biophysical Journal
https://www.readbyqxmd.com/read/27920706/ipilimumab-induced-enteritis-without-colitis-a-new-challenge
#2
Marcus Messmer, Sunita Upreti, Yaman Tarabishy, Nikhilesh Mazumder, Reezwana Chowdhury, Mark Yarchoan, Matthias Holdhoff
INTRODUCTION: Ipilimumab is an immune checkpoint inhibitor targeting cytotoxic T-lymphocyte associated antigen 4 (CTLA4), approved to treat metastatic melanoma. It was the first therapy shown to prolong survival in a large, randomized clinical trial. However, immune-related adverse events are common and can be severe. Enterocolitis is a common adverse event with ipilimumab, but enteritis without colitis has not been previously described. CASE REPORT: An 83-year-old man presented to our hospital with grade 3 diarrhea for 5 days...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27904113/fanconi-syndrome-associated-with-hyponatremia-in-two-patients-with-legionella-pneumonia
#3
Akihiro Ryuge, Yasuhiko Ito, Taishi Yamakawa, Hitoshi Tanaka, Hirotoshi Yasui, Shuko Mashimo, Kenshi Watanabe, Rie Nomura, Nobukazu Suganuma, Shoichi Maruyama
Legionella pneumophila is a cause of community-acquired pneumonia that is reported to induce electrolyte disorders, including hyponatremia, hypokalemia, and hypophosphatemia. We herein report two Japanese men with Legionella pneumonia and hyponatremia and hypophosphatemia. These findings were associated with an elevation of urinary low-molecular-weight tubular protein, including urinary β2-microglobulin, N-acetyl-β-D-glucosaminidase, the fractional excretion of phosphate and uric acid, and the presence of glycosuria and panaminoaciduria, suggesting that their electrolyte disorders had been caused by Fanconi syndrome...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904001/reninoma-masked-by-the-use-of-an-angiotensin-receptor-blocker
#4
Min Jung Kim, Joo Hui Kim, Il Young Kim, Dong Won Lee, Soo Bong Lee
Reninoma is a tumor that secretes excessive renin and is a rare cause of secondary hypertension. We report a case of reninoma with delayed diagnosis in a 33-year-old woman taking an angiotensin receptor blocker. During angiotensin receptor blocker medication, she had exhibited no electrolyte abnormality. The angiotensin receptor blocker was stopped for pregnancy planning purposes, and subsequent hypokalemia was observed. Abdominal computed tomography showed an enhanced round mass in the right kidney. Right partial nephrectomy was performed and the renal mass was removed...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27900368/whole-exome-sequencing-reveals-an-inherited-r566x-mutation-of-the-epithelial-sodium-channel-%C3%AE-subunit-in-a-case-of-early-onset-phenotype-of-liddle-syndrome
#5
Linda M Polfus, Eric Boerwinkle, Richard A Gibbs, Ginger Metcalf, Donna Muzny, Narayanan Veeraraghavan, Megan Grove, Sanjay Shete, Stephanie Wallace, Dianna Milewicz, Neil Hanchard, James R Lupski, Syed Shahrukh Hashmi, Monesha Gupta-Malhotra
To comprehensively evaluate a European-American child with severe hypertension, whole-exome sequencing (WES) was performed on the child and parents, which identified causal variation of the proband's early-onset disease. The proband's hypertension was resistant to treatment, requiring a multiple drug regimen including amiloride, spironolactone, and hydrochlorothiazide. We suspected a monogenic form of hypertension because of the persistent hypokalemia with low plasma levels of renin and aldosterone. To address this, we focused on rare functional variants and indels, and performed gene-based tests incorporating linkage scores and allele frequency and filtered on deleterious functional mutations...
November 2016: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/27896234/frequency-and-associated-factors-of-amphotericin-b-nephrotoxicity-in-hospitalized-patients-in-hematology-oncology-wards-in-the-southwest-of-iran
#6
Iman Karimzadeh, Marziyeh Heydari, Mani Ramzi, Mohammad Mahdi Sagheb
BACKGROUND: Nephrotoxicity is the most clinically significant adverse reaction of amphotericin B. Different aspects of amphotericin B (AmB) nephrotoxicity have not been studied well in our population. OBJECTIVES: The purpose of this study was to assess the frequency, time onset, and possible associated factors of AmB nephrotoxicity in hospitalized patients in hematology-oncology wards in the southwest of Iran. PATIENTS AND METHODS: A cross-sectional, observational study was performed over a period of 9 months at 2 hematology-oncology and 1 hematopoietic stem cell transplantation wards at Namazi Hospital...
September 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27888815/acute-diarrhoea-induced-by-rotavirus-in-children-hospitalysed-in-provincial-hospital-for-infectious-diseases-in-bydgoszcz-in-2014-year
#7
Beata Smok, Katarzyna Zieniewicz-Cieślik, Ewa Smukalska, Małgorzata Pawłowska
OBJECTIVE: The aim of the present study was to describe the epidemiology and course of rotavirus infection in children hospitalized at the T. Browicz Provincial Hospital for Infectious Diseases in Bydgoszcz, Poland in 2014 year. INTRODUCTION: Rotavirus infection is responsible for over 2 millions hospitalizations per year among children under 5 year old. Rotavirus gastroenterocolitis is one of the most common cause of severe dehydration, electrolyte disturbances and metabolic acidosis, leading to 400-600 thousand deaths per year in children younger than 5 years of age worldwide...
2016: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#8
M Kotoulová, I Mikysková, J Dušková, J Vláčil, M Dvořák, M Halaška
OBJECTIVE: The description of rare case of the Cushings syndrome in pregnancy resulting in the spontaneous rupture of uterus. DESIGNS: A case report. SETTING: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce. CASE REPORT: The authors report the case of a 33 year old woman, who was admitted to the clinic in 30th week of pregnancy for elevated blood pressure and hypokalemia...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27878411/reckless-administration-of-qt-interval-prolonging-agents-in-elderly-patients-with-drug-induced-torsade-de-pointes
#9
Galia Jackobson, Narin Nard Carmel, Dor Lotan, Anjelika Kremer, Dan Justo
A systematic review was conducted for all published case reports on drug-induced torsade de pointes (TdP) in elderly (≥80 years) patients to study if the administration of the offending agent was reckless. Overall, 61 reports on drug-induced TdP in patients aged 80-97 years were included in the analysis. Non-modifiable risk factors for drug-induced TdP (e.g. acute coronary syndrome, female gender and congestive heart failure), modifiable risk factors (e.g. hypokalemia, severe hypomagnesemia and digitalis toxicity) and reckless administration of a QT interval-prolonging agent (e...
November 22, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27876158/is-bicarbonate-therapy-useful
#10
REVIEW
Kate Hopper
Despite concerns about the negative effects of metabolic acidosis, there is minimal evidence that sodium bicarbonate administration is an effective treatment. In addition, sodium bicarbonate therapy is associated with many adverse effects, including paradoxic intracellular acidosis, hypokalemia, hypocalcemia, hypernatremia, and hyperosmolality. Definitive recommendations regarding bicarbonate therapy are challenging as there is little high-quality evidence available. In most clinical scenarios of metabolic acidosis, treatment efforts should focus on resolution of the underlying cause, and sodium bicarbonate therapy should be used with caution, if at all...
November 18, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27872838/new-slc12a3-disease-causative-mutation-of-gitelman-s-syndrome
#11
Teresa Grillone, Miranda Menniti, Francesco Bombardiere, Marco Flavio Michele Vismara, Stefania Belviso, Fernanda Fabiani, Nicola Perrotti, Rodolfo Iuliano, Emma Colao
Gitelman's syndrome (GS) is a salt-losing tubulopathy with an autosomal recessive inheritance caused by mutations of SLC12A3, which encodes for the thiazide-sensitive NaCl cotransporter. In this study we report a new mutation of SLC12A3 found in two brothers affected by GS. Hypokalemia, hypocalciuria and hyper-reninemia were present in both patients while hypomagnesemia was detected only in one. Both patients are compound heterozygotes carrying one well known GS associated mutation (c.2581 C > T) and a new one (c...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27872640/nucleotide-analogue-related-proximal-renal-tubular-dysfunction-during-long-term-treatment-of-chronic-hepatitis-b-a-cross-sectional-study
#12
Abhasnee Sobhonslidsuk, Jirachaya Wanichanuwat, Pawin Numthavaj, Areepan Sophonsritsuk, Supanna Petraksa, Alongkorn Pugasub, Paisan Jittorntam, Anucha Kongsomgan, Sittiruk Roytrakul, Bunyong Phakdeekitcharoen
Background. There have been few reports of nucleotide analogue-related renal tubular dysfunction (RTD) in CHB patients. We assessed the prevalence and presentation of nucleotide analogue-related proximal RTD. Methods. A cross-sectional study was performed in CHB patients taking nucleotide analogues. Inclusion criteria were patients who were on adefovir or tenofovir as mono- or add-on therapy with lamivudine (LAM) >1 year. Serum and urine were collected. Fractional excretion of phosphate (FEPO4), uric acid (FEUA), and potassium was calculated...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27869610/electrolyte-and-metabolic-disturbances-in-ebola-patients-during-a-clinical-trial-guinea-2015
#13
Johan van Griensven, Elhadj Ibrahima Bah, Nyankoye Haba, Alexandre Delamou, Bienvenu Salim Camara, Kadio Jean-Jacques Olivier, Hilde De Clerck, Helena Nordenstedt, Malcolm G Semple, Michel Van Herp, Jozefien Buyze, Maaike De Crop, Steven Van Den Broucke, Lutgarde Lynen, Anja De Weggheleire
By using data from a 2015 clinical trial on Ebola convalescent-phase plasma in Guinea, we assessed the prevalence of electrolyte and metabolic abnormalities at admission and their predictive value to stratify patients into risk groups. Patients underwent testing with a point-of-care device. We used logistic regression to construct a prognostic model and summarized the predictive value with the area under the receiver operating curve. Abnormalities were common among patients, particularly hypokalemia, hypocalcemia, hyponatremia, raised creatinine, high anion gap, and anemia...
December 2016: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/27865304/brain-natriuretic-peptide-counteracting-the-renin-angiotensin-aldosterone-system-in-accelerated-malignant-hypertension
#14
Hitoshi Nakagawa, Yuji Mizuno, Eisaku Harada, Yoshinobu Morikawa, Koichiro Kuwahara, Yoshihiko Saito, Hirofumi Yasue
We describe 2 patients, a 52-year-old woman and a 57-year-old man, with rapidly progressive hypertension and marked elevation of brain natriuretic peptide who exhibited polyuria, natriuresis, hypokalemia, posterior reversible encephalopathy syndrome and left ventricular dysfunction together with retinopathy and nephropathy, which were attenuated in a short time span of 1-2 months with normalization of blood pressure after the antihypertensive treatment. The possible role of brain natriuretic peptide in the pathophysiology of accelerated malignant hypertension was discussed and a review of the literature was completed...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27865300/effect-of-dapagliflozin-treatment-on-fluid-and-electrolyte-balance-in-diabetic-rats
#15
Ling Chen, Lauren M LaRocque, Orhan Efe, Juan Wang, Jeff M Sands, Janet D Klein
AIM: This study evaluates the effect of dapagliflozin, a SGLT2 inhibitor, on fluid or electrolyte balance and its effect on urea transporter-A1 (UT-A1), aquaporin-2 (AQP2) and Na-K-2Cl cotransporter (NKCC2) protein abundance in diabetic rats. METHODS: Diabetes mellitus (DM) was induced by injection of streptozotocin into the tail vein. Serum Na(+), K(+), Cl(-) concentration, urine Na(+), K(+), Cl(-) excretion, blood glucose, urine glucose excretion, urine volume, urine osmolality and urine urea excretion were analyzed after the administration of dapagliflozin...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27861219/rapidly-resolving-weakness-related-to-hypokalemia-in-patients-infected-with-dengue-virus
#16
Pradeep K Maurya, Dinkar Kulshreshtha, Ajai K Singh, Anup K Thacker
OBJECTIVES: Dengue is a mosquito-borne disease caused by arbovirus and well known for its typical fever with thrombocytopenia syndrome. Acute hypokalemic quadriparesis is a rare presentation of dengue with uncertain pathogenesis. We aim to describe the clinical and biochemical characteristics of rapidly resolving weakness related to hypokalemia in patients infected with dengue virus. METHODS: A retrospective review of the records of patients with diagnosis of dengue-associated hypokalemic weakness was performed...
December 2016: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/27857908/therapeutic-hypothermia-for-increased-intracranial-pressure-after-decompressive-craniectomy-a-single-center-experience
#17
Hyun Taek Rim, Jun Hyong Ahn, Ji Hee Kim, Jae Keun Oh, Joon Ho Song, In Bok Chang
OBJECTIVE: Therapeutic hypothermia (TH) and decompressive craniectomy are neuroprotective interventions following severe brain swelling. The precise benefits, risks, and clinical outcomes in brain swelling after TH are still being investigated. We aimed to investigate the effects of TH in severe brain injury after decompressive craniectomy. METHODS: We reviewed the cases of 24 patients who underwent decompressive craniectomy with intracranial pressure (ICP) monitor insertion in one medical center between January 2012 and May 2016...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857836/refractory-hypoglycemia-in-a-patient-with-functional-adrenal-cortical-carcinoma
#18
Katia Regina Marchetti, Maria Adelaide Albergaria Pereira, Arnaldo Lichtenstein, Edison Ferreira Paiva
: Adrenacarcinomas are rare, and hypoglycemic syndrome resulting from the secretion of insulin-like growth factor II (IGF-II) by these tumors have been described infrequently. This study describes the case of a young woman with severe persistent hypoglycemia and a large adrenal tumor and discusses the physiopathological mechanisms involved in hypoglycemia. The case is described as a 21-year-old woman who presented with 8 months of general symptoms and, in the preceding 3 months, with episodes of mental confusion and visual blurring secondary to hypoglycemia...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27855062/safety-tolerability-and-pharmacokinetics-of-liposomal-amphotericin-b-in-immunocompromised-pediatric-patients
#19
Nita L Seibel, Aziza T Shad, Ihor Bekersky, Andreas H Groll, Corina Gonzalez, Lauren V Wood, Paul Jarosinski, Donald Buell, William W Hope, Thomas J Walsh
The safety, tolerability and pharmacokinetics of liposomal formulation of amphotericin B (L-AMB) were evaluated in 40 immunocompromised children and adolescents. The protocol was an open-label, sequential-dose-escalation, multidose pharmacokinetic study with 10 to 13 patients in each of the four dosage cohorts. Each cohort received daily dosages of 2.5, 5.0, 7.5 or 10 mg of amphotericin B in the form of L-AMB per kg of body weight. Neutropenic patients between ages 1 and 17 years were enrolled to receive empirical antifungal therapy or treatment of documented invasive fungal infections...
November 14, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27853336/seventeen-alpha-hydroxylase-deficiency-associated-with-absent-gonads-and-myelolipoma-a-case-report-and-review-of-literature
#20
Mahmood Soveid, Ghanbar Ali Rais-Jalali
Congenital adrenal hyperplasia comprises a group of disorders resulting from defects in enzymes required for the synthesis of cortisol. The clinical presentation depends on the specific enzyme defect. We report a rare case of congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency. A 26-year-old female patient referred with hypertension and hypokalemia. She also had primary amenorrhea and lack of sexual development. The karyotype was 46, XY. Hormonal evaluation showed low serum levels of all steroid hormones, requiring alpha-hydroxylation, which included cortisol, 17 alpha-hydroxy progesterone, dehydroepiandrosterone sulfate, estradiol, and testosterone...
November 2016: Iranian Journal of Medical Sciences
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