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    1 OF 263

    Proximal Renal Tubular Acidosis (Fanconi syndrome) Induced by Apremilast: A Case Report.
    Am J Kidney Dis 2017 Aug 17. Epub 2017 Aug 17.
    Department of Nephrology, Orlando, FL.
    Apremilast is a recently developed phosphodiesterase 4-inhibitory medication approved for use to treat psoriasis and psoriatic arthritis. We report a case of Fanconi syndrome and proximal renal tubular acidosis that was associated with this medication. Our patient was started on treatment with apremilast 2 weeks before his admission. Read More

    K(+) deficiency caused defects in renal tubular cell proliferation, oxidative stress response, tissue repair and tight junction integrity, but enhanced energy production, proteasome function and cellular K(+) uptake.
    Cell Adh Migr 2017 Aug 18. Epub 2017 Aug 18.
    a Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital; and Center for Research in Complex Systems Science (CRCSS), Mahidol University , Bangkok , Thailand.
    Hypokalemia is a common electrolyte disorder in hospitalized patients and those with chronic diseases and is associated with renal tubular injury. Our recent expression proteomics study revealed changes in levels of several proteins in renal tubular cells during K(+) deficiency. However, functional significance and mechanisms underlying such changes remained unclear. Read More

    Inherited, not acquired, Gitelman syndrome in a patient with Sjögren's syndrome: importance of genetic testing to distinguish the two forms.
    CEN Case Rep 2017 Aug 17. Epub 2017 Aug 17.
    Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
    Gitelman syndrome (GS) is an autosomal recessive, salt-losing renal tubulopathy caused by mutations in the SLC12A3 gene; however, it can also be acquired in patients with autoimmune disease, especially in those with Sjögren's syndrome. Differentiating between the inherited and acquired forms of GS is clinically difficult. We report a case of inherited, not acquired, GS in a patient with Sjögren's syndrome. Read More

    Voriconazole Antifungal Prophylaxis in Children With Malignancies: A Nationwide Study.
    J Pediatr Hematol Oncol 2017 Aug 14. Epub 2017 Aug 14.
    *Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences ‡Pediatric Oncology Department, Hippokration General Hospital †Hematology/Oncology Unit, 2nd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, AHEPA General Hospital, Thessaloniki §Pediatric Hematology/Oncology Unit, 1st Department of Pediatrics, Athens University Medical School #Department of Pediatric Hematology/Oncology **Bone Marrow Transplantation Unit, Athens University Medical School, Aghia Sophia Children's Hospital, Athens ∥Department of Pediatric Hematology/Oncology, University of Crete Medical School, University Hospital of Heraklion, Irakleio ¶Pediatric Hematology/Oncology Department, Aglaia Kyriakou Children's Hospital, Athens, Greece.
    Background: Antifungal prophylaxis (AFP) is recommended in at-risk hematology-oncology patients. We evaluated the safety of AFP with voriconazole (VRC) in pediatric hematology/oncology patients.

    Materials And Methods: A retrospective study of VRC AFP in children with malignancies hospitalized in all 7 Greek pediatric hematology/oncology centers during 2008 to 2012 was conducted. Read More

    Retrospective review of SGLT2 inhibitor exposures reported to 13 poison centers.
    Clin Toxicol (Phila) 2017 Aug 16:1-5. Epub 2017 Aug 16.
    f Louisiana Poison Center , Shreveport , LA , USA.
    Background: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. Read More

    Electrolytes: Potassium Disorders.
    FP Essent 2017 Aug;459:21-28
    Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310.
    Hypokalemia (ie, potassium levels less than 3.5 mEq/L) occurs in fewer than 1% of healthy individuals, but is present in up to 20% of hospitalized patients, 40% of patients taking diuretics, and 17% of patients with cardiovascular conditions. Hypokalemia often is asymptomatic; symptoms are more common in older adults. Read More

    Evaluation of clinical, laboratory, imaging findings and outcome in 99 dogs with leptospirosis.
    J Small Anim Pract 2017 Aug 14. Epub 2017 Aug 14.
    Clinic for Small Animals, Freie Universität Berlin, Oertzenweg 19b, D-14163 Berlin.
    Objective: To report clinical, laboratory and diagnostic imaging features and prognostic factors in dogs with leptospirosis from North-East Germany.

    Materials And Methods: Medical records of dogs diagnosed with leptospirosis from 2006 to 2013 were evaluated retrospectively.

    Results: The study included 99 dogs. Read More

    Temporal Pattern and Prognostic Significance of Hypokalemia in Patients Undergoing Targeted Temperature Management Following Cardiac Arrest.
    Am J Cardiol 2017 Jul 17. Epub 2017 Jul 17.
    Vanderbilt University Medical Center, Nashville, Tennessee.
    Hypokalemia has been consistently reported as a common occurrence during targeted temperature management (TTM) in comatose survivors of cardiac arrest. We sought to better describe changes in serum potassium throughout the different stages of TTM and to assess for any prognostic significance. We analyzed a prospectively collected cohort of 240 patients treated with TTM following cardiac arrest at a tertiary care hospital between 2007 and 2014. Read More

    Increased afterload following myocardial infarction promotes conduction-dependent arrhythmias that are unmasked by hypokalemia.
    JACC Basic Transl Sci 2017 Jun 26;2(3):258-269. Epub 2017 Jun 26.
    Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    Although the pathophysiological significance of resistant hypertension in post-myocardial infarction (MI) patients is established, mechanisms by which increased afterload in that setting worsens outcome are unclear. With regards to sudden cardiac death, whether increased afterload alters the electrophysiological substrate following MI is unknown. We established a new large animal model of chronic post-MI remodeling with increased afterload which exhibits widespread deposition of fibrosis in remote areas from the anterior MI, mimicking the disease phenotype of patients with advanced ischemic heart disease. Read More

    Persisting fatigue and myalgia as the presenting features in a case of hypokalaemic periodic paralysis.
    BMJ Case Rep 2017 Aug 10;2017. Epub 2017 Aug 10.
    Paediatrics, East Cheshire NHS Trust, Macclesfield, Cheshire East, UK.
    We report a case of a 9-year-old boy who developed hypokalaemic periodic paralysis (HypoPP) following a prodrome of persistent fatigue and muscle aches associated with mildly elevated creatine kinase (CK) levels.HypoPP is usually associated with a sudden onset of weakness and hypokalaemia at presentation. A review of published cases failed to identify any other reports of individuals with a similar onset of symptoms and elevated CK levels prior to the development of frank HypoPP. Read More

    Congenital Adrenal Hyperplasia with 11-Beta Hydroxylase Deficiency with Testicular Adrenal Rest Tumour.
    J Assoc Physicians India 2017 Jun;65(6):97-99
    Assistant Professor in Medicine, Seth GSMC and KEM Hospital, Mumbai, Maharashtra.
    Congenital adrenal hyperplasia refers to the non-malignant enlargement of adrenal gland tissue as a result of deficiency of one of several enzymes involved in adrenal hormone synthesis, secondary to a genetic mutation. 11 - Beta hydroxylase is one such enzyme, and its deficiency is a rare cause of Congenital Adrenal Hyperplasia. We describe the case of an 18-year old man who presented to us with an acute right ganglio-capsular bleed, hypertension and bilateral scrotal swelling. Read More

    Multiplex epithelium dysfunction due to CLDN10 mutation: the HELIX syndrome.
    Genet Med 2017 Aug 3. Epub 2017 Aug 3.
    Qatar Biomedical Research Institute, Hamad Ben Khalifa University, Doha, Qatar.
    PurposeWe aimed to identify the genetic cause to a clinical syndrome encompassing hypohidrosis, electrolyte imbalance, lacrimal gland dysfunction, ichthyosis, and xerostomia (HELIX syndrome), and to comprehensively delineate the phenotype.MethodsWe performed homozygosity mapping, whole-genome sequencing, gene sequencing, expression studies, functional tests, protein bioinformatics, and histological characterization in two unrelated families with HELIX syndrome.ResultsWe identified biallelic missense mutations (c. Read More

    A comparative study of QT prolongation with serotonin reuptake inhibitors.
    Psychopharmacology (Berl) 2017 Aug 3. Epub 2017 Aug 3.
    Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Pharmacopôle Midi-Pyrénées, INSERM UMR 1027, CIC INSERM 1436, CHU et Faculté de Médecine de Toulouse, Toulouse, France.
    Background: QT interval prolongations were described with citalopram and escitalopram. However, the effects of the other serotonin reuptake inhibitors (SRIs) remained discussed. In order to identify a putative signal with other SRIs, the present study investigates the reports of QT interval prolongation with SRIs in two pharmacovigilance databases (PVDB). Read More

    Expanding the differential: toluene-induced toxicity.
    BMJ Case Rep 2017 Aug 1;2017. Epub 2017 Aug 1.
    Department of Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
    A 31-year-old woman presented to the hospital with generalised weakness and lower back and abdominal pain. The only significant finding on physical examination was the weakness of the legs. Laboratory analysis in the emergency department revealed that she was hypokalaemic with metabolic acidosis. Read More

    Severe hypokalaemia as a cause of acute transient quadriparesis.
    BMJ Case Rep 2017 Jul 27;2017. Epub 2017 Jul 27.
    Department of Internal Medicine, Regionshospitalet Randers, Randers, Denmark.
    Hypokalaemic paralysis covers a heterogeneous group of disorders caused either by an enhanced shift of potassium into the cells or following a significant renal or gastrointestinal loss of potassium. We present the case of a 48-year-old Caucasian man with paralysis of both upper and lower extremities. ECG showed sinus rhythm and characteristic changes of hypokalaemia with depression of the ST segment, prolonged QTc interval of 581ms and U waves seen as a small positive deflection at the T wave in the middle precordial leads. Read More

    Evidence-based management of potassium disorders in the emergency department [digest].
    Emerg Med Pract 2016 Nov 22;18(11 Suppl Points & Pearls):S1-S2. Epub 2016 Nov 22.
    Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
    Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. Read More

    Peptide Receptor Radionuclide Therapy-Induced Gitelman-like Syndrome.
    Am J Kidney Dis 2017 Jul 21. Epub 2017 Jul 21.
    Emergency Department, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
    Peptide receptor radionuclide therapy (PRRT) is a molecular-targeted therapy in which a somatostatin analogue (a small peptide) is coupled with a radioligand so that the radiation dose is selectively administered to somatostatin receptor-expressing metastasized neuroendocrine tumors, particularly gastroenteropancreatic. Reported toxicities include myelotoxicity and nephrotoxicity, the latter manifesting as decreased kidney function, often developing months to years after treatment completion. We present a case of PRRT-induced kidney toxicity manifesting as a severe Gitelman-like tubulopathy with preserved kidney function. Read More

    Admission serum potassium concentration and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry.
    BMC Cardiovasc Disord 2017 Jul 24;17(1):198. Epub 2017 Jul 24.
    MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany.
    Background: Conflicting with clinical practice guidelines, recent studies demonstrated that serum potassium concentrations (SPC) of ≥4.5 mEq/l were associated with increased mortality in patients with acute myocardial infarction (AMI). This study examined the association between SPC and long-term mortality following AMI in patients recruited from a population-based registry. Read More

    Impact of Renin-Angiotensin Aldosterone System Inhibition on Serum Potassium Levels among Peritoneal Dialysis Patients.
    Am J Nephrol 2017 Jul 22;46(2):150-155. Epub 2017 Jul 22.
    Background: The chronic use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker has been associated with hyperkalemia in patients with reduced renal function even after the initiation of hemodialysis. Whether such medications may cause a similar effect in peritoneal dialysis patients is not well established. So, the aim of our study was to analyze the impact of renin-angiotensin-aldosterone inhibitors on the serum levels of potassium in a national cohort of peritoneal dialysis patients. Read More

    Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system.
    Int J Cardiol 2017 Jul 15. Epub 2017 Jul 15.
    Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Sweden. Electronic address:
    Background: Hypo- and hyperkalemia in clinical settings are insufficiently characterized and large-scale data from Europe lacking. We studied incidence and determinants of these abnormalities in a large Swedish healthcare system.

    Methods: Observational study from the Stockholm CREAtinine Measurements project, including adult individuals from Stockholm accessing healthcare in 2009 (n=364,955). Read More

    Persistent hypokalemia with renal losses in a 31-year-old pregnant woman.
    Gastroenterology 2017 Jul 18. Epub 2017 Jul 18.
    Service de néphrologie, Hôpital Bichat-Claude Bernard, AP-HP, DHU Fire, Paris 75018 Paris; Université Paris Diderot, Sorbonne Paris Cité, Paris 75018, France; INSERM 1149, Centre de Recherche sur l'Inflammation, Paris 75018, France. Electronic address:

    Electrolyte disorders with platinum-based chemotherapy: mechanisms, manifestations and management.
    Cancer Chemother Pharmacol 2017 Jul 20. Epub 2017 Jul 20.
    Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20889, USA.
    Platinum chemotherapy, particularly cisplatin, is commonly associated with electrolyte imbalances, including hypomagnesemia, hypokalemia, hypophosphatemia, hypocalcemia and hyponatremia. The corpus of literature on these dyselectrolytemias is large; the objective of this review is to synthesize the literature and summarize the mechanisms responsible for these particular electrolyte disturbances in the context of platinum-based treatment as well as to present the clinical manifestations and current management strategies for oncologists and primary care physicians, since the latter are increasingly called on to provide care for cancer patients with medical comorbidities. Correct diagnosis and effective treatment are essential to improved patient outcomes. Read More

    Verner-Morrison syndrome. Literature review.
    Rom J Morphol Embryol 2017 ;58(2):371-376
    Department of Pediatric Surgery, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Department of Neonatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania;
    Chronic diarrhea in infants is a common condition for addressability to pediatric gastroenterologists. The causes are multiple and the delay in reaching the final diagnosis can lead to complications in the general condition of the child. The purpose of this review is to present the bio-clinical and histogenetic particularities of a rare clinical entity, characterized by tumoral causes of chronic diarrhea. Read More

    Gastroenterol Nurs 2017 Jul 19. Epub 2017 Jul 19.
    Emrah Posul, MD, Department of Gastroenterology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. Guray Can, MD, Department of Gastroenterology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. Vildan Tekelioglu, MD, Department of Internal Medicine, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. Bulent Yilmaz, MD, Department of Gastroenterology, Bolu Izzet Baysal State Hospital, Bolu, Turkey. Ugur Korkmaz, MD, is Associate Professor, Department of Gastroenterology, Bolu Izzet Baysal State Hospital, Bolu, Turkey. Gulzade Ozyalvacli, MD, is Assistant Professor, Department of Pathology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. Asuman Kilitci, MD, Department of Pathology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. Mevlut Kurt, MD, is Associate Professor, Department of Gastroenterology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.

    Tubulointerstitial nephritis-induced hypophosphatemic osteomalacia in Sjögren's syndrome: a case report and review of the literature.
    Clin Rheumatol 2017 Jul 20. Epub 2017 Jul 20.
    Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
    Sjögren's syndrome (SS) is a chronic autoimmune inflammatory disease that typically affects the salivary and lacrimal glands. Renal involvement is relatively uncommon and may precede other complaints. Tubulointestitial nephritis (TIN) is the most common renal involvement in SS. Read More

    [Disorders of water and electrolyte metabolism and changes in acid-base balance in patients with ascitic liver cirrhosis].
    Cas Lek Cesk 2017 ;156(3):150-152
    In patients with advanced cirrhosis with ascites disorders of water and electrolyte metabolism are often present and they are associated with changes in acid-base balance. These changes can be very complicated, their diagnosis and treatment difficult. Dilutional hyponatremia is the most common disorder. Read More

    Genetic screening of SCNN1B and SCNN1G genes in early-onset hypertensive patients helps to identify Liddle syndrome.
    Clin Exp Hypertens 2017 Jul 18:1-5. Epub 2017 Jul 18.
    a Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China.
    Background: Liddle syndrome is an autosomal dominant form of monogenic hypertension. Phenotypic variability makes it difficult to identify patients with Liddle syndrome, resulting in misdiagnosis and severe complications at early age.

    Objectives: To identify mutation in SCNN1B and SCNN1G genes in an adolescent with suspicious Liddle syndrome and his family members and to explore the screening target subjects of Liddle syndrome. Read More

    A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes.
    Clin Exp Emerg Med 2017 Jun 30;4(2):73-79. Epub 2017 Jun 30.
    Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
    Objective: Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients.

    Methods: We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Read More

    Age and gender-related peculiarities of patients with delirium in the cardiac intensive care unit.
    Kardiol Pol 2017 Jul 17. Epub 2017 Jul 17.
    Vilnius University Hospital Santariskiu Klinikos, Centre of Cardiology and Angiology,, Vilnius, Lithuania, Lithuania.
    Background: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender. Read More

    Care of Metabolic and Endocrine Conditions in the Observation Unit.
    Emerg Med Clin North Am 2017 Aug;35(3):589-601
    Department of Emergency Medicine, Emory University Hospital School of Medicine, Emory University Hospital, 531 Asbury Circle-Annex, Suite N340, Atlanta, GA 30322, USA. Electronic address:
    Accelerated therapeutic protocols targeting metabolic conditions are ideal for observation unit care. Because many conditions, such as hypokalemia and hyperglycemia, have little to no diagnostic uncertainty, the care in the unit is often straightforward. Additionally, some components of care for the endocrine condition may exhaust services, such as phlebotomy. Read More

    A Missense Mutation in the Extracellular Domain of αENaC Causes Liddle Syndrome.
    J Am Soc Nephrol 2017 Jul 14. Epub 2017 Jul 14.
    Departments of Internal Medicine and
    Liddle syndrome is an autosomal dominant form of hypokalemic hypertension due to mutations in the β- or γ-subunit of the epithelial sodium channel (ENaC). Here, we describe a family with Liddle syndrome due to a mutation in αENaC. The proband was referred because of resistant hypokalemic hypertension, suppressed renin and aldosterone, and no mutations in the genes encoding β- or γENaC. Read More

    Identifying unilateral disease in Chinese patients with primary aldosteronism by using a modified prediction score.
    J Hypertens 2017 Jul 20. Epub 2017 Jul 20.
    aDepartment of Hypertension bShanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai cDepartment of Cardiology, Tongji Hospital, Tongji University dDepartment of Radiology eDepartment of Urology of Luwan Branch fDepartment of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
    Objective: The current study aimed to evaluate the role of Küpers' score in predicting unilateral aldosteronism, and develop a modified score in Chinese patients with primary aldosteronism.

    Methods: The current retrospective study included 406 patients with primary aldosteronism who underwent successful adrenal venous sampling (AVS) and were divided into the unilateral (n = 211) and bilateral (n = 195) groups according to the AVS results. Normokalemia was noted in both the unilateral (n = 64) and bilateral groups (n = 84) when plasma and urinary aldosterone were measured. Read More

    Role of abnormal repolarization in the mechanism of cardiac arrhythmia.
    Acta Physiol (Oxf) 2017 Jul;220 Suppl 712:1-71
    Department of Health Science and Technology, University of Aalborg, Aalborg, Denmark.
    In cardiac patients, life-threatening tachyarrhythmia is often precipitated by abnormal changes in ventricular repolarization and refractoriness. Repolarization abnormalities typically evolve as a consequence of impaired function of outward K(+) currents in cardiac myocytes, which may be caused by genetic defects or result from various acquired pathophysiological conditions, including electrical remodelling in cardiac disease, ion channel modulation by clinically used pharmacological agents, and systemic electrolyte disorders seen in heart failure, such as hypokalaemia. Cardiac electrical instability attributed to abnormal repolarization relies on the complex interplay between a provocative arrhythmic trigger and vulnerable arrhythmic substrate, with a central role played by the excessive prolongation of ventricular action potential duration, impaired intracellular Ca(2+) handling, and slowed impulse conduction. Read More

    Epidemiological and clinical characteristics of 304 patients with infantile hypertrophic pyloric stenosis in Anhui Province of East China, 2012-2015.
    J Matern Fetal Neonatal Med 2017 Jul 27:1-6. Epub 2017 Jul 27.
    b Department of Pediatric Surgery , Anhui Provincial Children's Hospital , Hefei , Anhui , China.
    Objective: To analyze the clinical and epidemiological features of patients with infantile hypertrophic pyloric stenosis (IHPS) so as to provide scientific evidence for diagnosis and prevention of IHPS.

    Methods: We performed a retrospective study of infants with IHPS diagnosed from 2012 to 2015 at Anhui Provincial Children's Hospital. Demographic characteristics and clinical data were collected. Read More

    Increased urinary prostaglandin E2 metabolite: A potential therapeutic target of Gitelman syndrome.
    PLoS One 2017 10;12(7):e0180811. Epub 2017 Jul 10.
    Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
    Background: Gitelman syndrome (GS), an inherited autosomal recessive salt-losing renal tubulopathy caused by mutations in SLC12A3 gene, has been associated with normal prostaglandin E2 (PGE2) levels since 1995 by a study involving 11 clinically diagnosed patients. However, it is difficult to explain why cyclooxygenase-2 (COX2) inhibitors, which pharmacologically reduce PGE2 synthesis, are helpful to patients with GS, and few studies performed in the last 20 years have measured PGE2 levels. The relationships between the clinical manifestations and PGE2 levels were never thoroughly analyzed. Read More

    Diagnosis and management of primary aldosteronism.
    Arch Endocrinol Metab 2017 May-Jun;61(3):305-312
    Unidade de Suprarrenal, Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular - LIM42, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brasil.
    Primary aldosteronism (PA) is the most common form of secondary hypertension (HTN), with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential HTN and the same degree of blood pressure elevation. PA is characterized by an autonomous aldosterone production causing sodium retention, plasma renin supression, HTN, cardiovascular damage, and increased potassium excretion, leading to variable degrees of hypokalemia. Read More

    Reversible Hypokalemia and Bartter-Like Syndrome during Prolonged Systemic Therapy with Colistimethate Sodium in an Adult Patient.
    Drug Saf Case Rep 2017 Dec;4(1):10
    Section of Viral Diseases, Department of Clinical Medicine, University Hospital 'Federico II' of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.
    We present the case of a 58-year-old woman who developed hypokalaemia and metabolic alkalosis 2 weeks after therapy with colistimethate sodium for the treatment of chronic lower limb ulcer infection by extensively drug-resistant (XDR) Pseudomonas aeruginosa. The metabolic changes observed resembled Bartter syndrome, a group of congenital disorders affecting the distal segments of the renal tubules. The metabolic abnormalities reversed spontaneously 6 days after drug discontinuation. Read More

    [Poor weight gain, recurrent metabolic alkalosis and hypokalemia in a neonate].
    Zhongguo Dang Dai Er Ke Za Zhi 2017 Jul;19(7):812-815
    Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China.
    The study reports a female neonate with a gestational age of 29(+2) weeks and a birth weight of 1 210 g. Ten minutes after birth, the neonate was admitted to the hospital due to shortness of breath. Several days after birth, the neonate presented with hyperglycemia, polyuria, and poor weight gain, accompanied by azotemia, hypochloremic metabolic alkalosis, hypokalemia, and hyponatremia. Read More

    Electrolyte and Acid-Base Abnormalities in Infants with Community-Acquired Acute Pyelonephritis: Prospective Cross-Sectional Study.
    Nephron 2017 Jul 12. Epub 2017 Jul 12.
    Pediatric Unit, Department of Clinical Sciences and Community Health, Ospedale Maggiore Policlinico, Università Degli Studi di Milano, Milan, Italy.
    Background: Retrospective case series suggest that abnormalities in fluid, electrolyte, and acid-base homeostasis may occur among infants with a febrile urinary tract infection. Potentially inaccurate laboratory methods of sodium testing have often been used.

    Methods: Between January 2009 and June 2016, we managed 80 previously healthy infants (52 males and 28 females) ≥4 weeks to ≤24 months of age with their first episode of acute pyelonephritis. Read More

    The adverse effects and choice of injectable agents in MDR-TB: amikacin or capreomycin.
    Antimicrob Agents Chemother 2017 Jul 10. Epub 2017 Jul 10.
    Institute for Infection and Immunity, St. George's University of London, London, United Kingdom.
    Background: The prolonged use of injectable agents in an MDR-TB regimen is recommended by the WHO despite association with ototoxicity and nephrotoxicity.Objective: We undertook this study to look at the relative adverse effects of capreomycin and amikacin.Methods: We reviewed the case notes of 100 consecutive patients treated at 4 MDR-TB treatment centres in the UK. Read More

    The impact of hypothermia on serum potassium concentration: A systematic review.
    Resuscitation 2017 Sep 5;118:35-42. Epub 2017 Jul 5.
    Department of Emergency Medicine, SAMU 38, University Hospital of Grenoble Alps, Grenoble, France. Electronic address:
    Background: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories.

    Methods: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. Read More

    Acquired Gitelman syndrome in a primary Sjögren syndrome patient with a SLC12A3 heterozygous mutation: A case report and literature review.
    Nephrology (Carlton) 2017 Aug;22(8):652-655
    Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
    Acquired Gitelman's syndrome (GS) associated with Sjögren syndrome (SS) is rare. A 50-year-old woman was admitted to our department because of nausea, acratia and sicca complex. Laboratory tests after admission showed renal failure, hypokalaemia, metabolic alkalosis, hypomagnesaemia and hypocalciuria, all of which met the diagnostic criteria for GS. Read More

    Comparison of long-term safety of fixed-dose combinations azilsartan medoxomil/chlorthalidone vs olmesartan medoxomil/hydrochlorothiazide.
    J Clin Hypertens (Greenwich) 2017 Jul 6. Epub 2017 Jul 6.
    Takeda Pharmaceuticals International, Inc., Deerfield, IL, USA.
    This 52-week, randomized, open-label study evaluated long-term safety/tolerability of fixed-dose combination azilsartan medoxomil/chlorthalidone (AZL-M/CLD) vs fixed-dose combination olmesartan medoxomil/hydrochlorothiazide (OLM/HCTZ) in patients with essential hypertension (stage 2; clinic systolic blood pressure 160-190 mm Hg). Initial AZL-M/CLD 40/12.5 mg/d (n=418) or OLM/HCTZ 20/12. Read More

    A rare case of an ACTH/CRH co-secreting midgut neuroendocrine tumor mimicking Cushing's disease.
    Endocrinol Diabetes Metab Case Rep 2017 16;2017. Epub 2017 Jun 16.
    Division of Endocrinology and Diabetes, Department of Internal Medicine.
    Ectopic ACTH/CRH co-secreting tumors are a very rare cause of Cushing's syndrome and only a few cases have been reported in the literature. Differentiating between Cushing's disease and ectopic Cushing's syndrome may be particularly difficult if predominant ectopic CRH secretion leads to pituitary corticotroph hyperplasia that may mimic Cushing's disease during dynamic testing with both dexamethasone and CRH as well as bilateral inferior petrosal sinus sampling (BIPSS). We present the case of a 24-year-old man diagnosed with ACTH-dependent Cushing's syndrome caused by an ACTH/CRH co-secreting midgut NET. Read More

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