Metabolic alkalosis differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
m Bot: Removing from Primary care |
|||
| (9 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Metabolic_alkalosis]] | |||
{{CMG}}; {{AE}}{{SSH}} | {{CMG}}; {{AE}}{{SSH}} | ||
| Line 73: | Line 73: | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Clinical | | align="center" style="background:#F5F5F5;" + |Clinical manifestations | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Post treatment of [[lactic acidosis]] or [[ketoacidosis]] | * Post treatment of [[lactic acidosis]] or [[ketoacidosis]] | ||
* Increased risk of [[Kidney stone|renal stones]] | * Increased risk of [[Kidney stone|renal stones]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Milk−alkali syndrome<ref name="Abreo1993">{{cite journal|last1=Abreo|first1=Kenneth|title=The Milk-Alkali Syndrome|journal=Archives of Internal Medicine|volume=153|issue=8|year=1993|pages=1005|issn=0003-9926|doi=10.1001/archinte.1993.00410080065011}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Milk-alkali syndrome|Milk−alkali syndrome]]<ref name="Abreo1993">{{cite journal|last1=Abreo|first1=Kenneth|title=The Milk-Alkali Syndrome|journal=Archives of Internal Medicine|volume=153|issue=8|year=1993|pages=1005|issn=0003-9926|doi=10.1001/archinte.1993.00410080065011}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| Line 101: | Line 101: | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Clinical + exclusion of other causes of [[hypercalcemia]] | | align="center" style="background:#F5F5F5;" + |Clinical manifestationsk + exclusion of other causes of [[hypercalcemia]] | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Ingestion of large amounts of calcium and absorbable alkali | * Ingestion of large amounts of calcium and absorbable alkali | ||
* [[Acute kidney injury]] | * [[Acute kidney injury]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Transfusion<ref name="pmid14712429">{{cite journal |vauthors=Gupta M, Wadhwa NK, Bukovsky R |title=Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate |journal=Am. J. Kidney Dis. |volume=43 |issue=1 |pages=67–73 |date=January 2004 |pmid=14712429 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Transfusion]]<ref name="pmid14712429">{{cite journal |vauthors=Gupta M, Wadhwa NK, Bukovsky R |title=Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate |journal=Am. J. Kidney Dis. |volume=43 |issue=1 |pages=67–73 |date=January 2004 |pmid=14712429 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| Line 134: | Line 134: | ||
|- | |- | ||
! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Drugs/Medication | ! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Drugs/Medication | ||
! align="center" style="background:#DCDCDC;" + |Chloruretic diuretics<ref name="LukeGalla2012">{{cite journal|last1=Luke|first1=R. G.|last2=Galla|first2=J. H.|title=It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis|journal=Journal of the American Society of Nephrology|volume=23|issue=2|year=2012|pages=204–207|issn=1046-6673|doi=10.1681/ASN.2011070720}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Diuretics|Chloruretic diuretics]]<ref name="LukeGalla2012">{{cite journal|last1=Luke|first1=R. G.|last2=Galla|first2=J. H.|title=It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis|journal=Journal of the American Society of Nephrology|volume=23|issue=2|year=2012|pages=204–207|issn=1046-6673|doi=10.1681/ASN.2011070720}}</ref> | ||
! align="left" style="background:#DCDCDC;" + | | ! align="left" style="background:#DCDCDC;" + | | ||
* Bumetanide | * [[Bumetanide]] | ||
* Chlorothiazide | * [[Chlorothiazide]] | ||
* Metolazone | * [[Metolazone]] | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 165: | Line 165: | ||
* [[Contraction alkalosis]] | * [[Contraction alkalosis]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Penicillin<ref name="ZakiLad2011">{{cite journal|last1=Zaki|first1=SyedAhmed|last2=Lad|first2=Vijay|title=Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis|journal=Indian Journal of Pharmacology|volume=43|issue=5|year=2011|pages=609|issn=0253-7613|doi=10.4103/0253-7613.84986}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Penicillin]]<ref name="ZakiLad2011">{{cite journal|last1=Zaki|first1=SyedAhmed|last2=Lad|first2=Vijay|title=Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis|journal=Indian Journal of Pharmacology|volume=43|issue=5|year=2011|pages=609|issn=0253-7613|doi=10.4103/0253-7613.84986}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 215: | Line 215: | ||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | | align="center" style="background:#F5F5F5;" + |Nl to ↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Clinical | | align="center" style="background:#F5F5F5;" + |Clinical manifestations | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Muscle weakness]] | * [[Muscle weakness]] | ||
| Line 221: | Line 221: | ||
* [[Paralysis]] | * [[Paralysis]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Laxative abuse<ref name="RoerigSteffen2010">{{cite journal|last1=Roerig|first1=James L.|last2=Steffen|first2=Kristine J.|last3=Mitchell|first3=James E.|last4=Zunker|first4=Christie|title=Laxative Abuse|journal=Drugs|volume=70|issue=12|year=2010|pages=1487–1503|issn=0012-6667|doi=10.2165/11898640-000000000-00000}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Laxative abuse]]<ref name="RoerigSteffen2010">{{cite journal|last1=Roerig|first1=James L.|last2=Steffen|first2=Kristine J.|last3=Mitchell|first3=James E.|last4=Zunker|first4=Christie|title=Laxative Abuse|journal=Drugs|volume=70|issue=12|year=2010|pages=1487–1503|issn=0012-6667|doi=10.2165/11898640-000000000-00000}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 250: | Line 250: | ||
* [[Weight loss]] | * [[Weight loss]] | ||
|- | |- | ||
! align="center" style="background:#DCDCDC;" + |Antacids<ref name="SahaniBrennan2001">{{cite journal|last1=Sahani|first1=Mandeep M.|last2=Brennan|first2=John F.|last3=Nwakanma|first3=Chukwuemeka|last4=Chow|first4=May T.|last5=Ing|first5=Todd S.|last6=Leehey|first6=David J.|title=Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication|journal=Artificial Organs|volume=25|issue=4|year=2001|pages=313–315|issn=0160-564X|doi=10.1046/j.1525-1594.2001.06714.x}}</ref><ref name="VanpeeDelgrange2000">{{cite journal|last1=Vanpee|first1=Dominique|last2=Delgrange|first2=Etienne|last3=Gillet|first3=Jean-Bernard|last4=Donckier|first4=Julian|title=Ingestion of antacid tablets (Rennie®) and acute confusion|journal=The Journal of Emergency Medicine|volume=19|issue=2|year=2000|pages=169–171|issn=07364679|doi=10.1016/S0736-4679(00)00206-7}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Antacids]]<ref name="SahaniBrennan2001">{{cite journal|last1=Sahani|first1=Mandeep M.|last2=Brennan|first2=John F.|last3=Nwakanma|first3=Chukwuemeka|last4=Chow|first4=May T.|last5=Ing|first5=Todd S.|last6=Leehey|first6=David J.|title=Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication|journal=Artificial Organs|volume=25|issue=4|year=2001|pages=313–315|issn=0160-564X|doi=10.1046/j.1525-1594.2001.06714.x}}</ref><ref name="VanpeeDelgrange2000">{{cite journal|last1=Vanpee|first1=Dominique|last2=Delgrange|first2=Etienne|last3=Gillet|first3=Jean-Bernard|last4=Donckier|first4=Julian|title=Ingestion of antacid tablets (Rennie®) and acute confusion|journal=The Journal of Emergency Medicine|volume=19|issue=2|year=2000|pages=169–171|issn=07364679|doi=10.1016/S0736-4679(00)00206-7}}</ref> | ||
! align="left" style="background:#DCDCDC;" + | | ! align="left" style="background:#DCDCDC;" + | | ||
* Aluminum hydroxide | * Aluminum hydroxide | ||
| Line 276: | Line 276: | ||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | | align="center" style="background:#F5F5F5;" + |Nl to ↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Clinical | | align="center" style="background:#F5F5F5;" + |Clinical manifestations | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Not applicable | * Not applicable | ||
| Line 308: | Line 308: | ||
|- | |- | ||
! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin | ! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Vomiting<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vomiting]]<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 331: | Line 331: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |↓ | | align="center" style="background:#F5F5F5;" + |↓ | ||
| align="center" style="background:#F5F5F5;" + |Clinical | | align="center" style="background:#F5F5F5;" + |Clinical manifestations | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Not applicable | * Not applicable | ||
| Line 358: | Line 358: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |↓ | | align="center" style="background:#F5F5F5;" + |↓ | ||
| align="center" style="background:#F5F5F5;" + |Clinical | | align="center" style="background:#F5F5F5;" + |Clinical manifestations | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Gastroesophageal reflux disease|GERD]] | * [[Gastroesophageal reflux disease|GERD]] | ||
* [[Pulmonary aspiration]] | * [[Pulmonary aspiration]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Zollinger−Ellison syndrome<ref name="HungSchubert2003">{{cite journal|last1=Hung|first1=Patrick D.|last2=Schubert|first2=Mitchell L.|last3=Mihas|first3=Anastasios A.|title=Zollinger-Ellison syndrome|journal=Current Treatment Options in Gastroenterology|volume=6|issue=2|year=2003|pages=163–170|issn=1092-8472|doi=10.1007/s11938-003-0017-6}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Zollinger-Ellison syndrome|Zollinger−Ellison syndrome]]<ref name="HungSchubert2003">{{cite journal|last1=Hung|first1=Patrick D.|last2=Schubert|first2=Mitchell L.|last3=Mihas|first3=Anastasios A.|title=Zollinger-Ellison syndrome|journal=Current Treatment Options in Gastroenterology|volume=6|issue=2|year=2003|pages=163–170|issn=1092-8472|doi=10.1007/s11938-003-0017-6}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 392: | Line 392: | ||
* [[MEN1]] | * [[MEN1]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Bulimia nervosa<ref name="ShapiroBerkman2007">{{cite journal|last1=Shapiro|first1=Jennifer R.|last2=Berkman|first2=Nancy D.|last3=Brownley|first3=Kimberly A.|last4=Sedway|first4=Jan A.|last5=Lohr|first5=Kathleen N.|last6=Bulik|first6=Cynthia M.|title=Bulimia nervosa treatment: A systematic review of randomized controlled trials|journal=International Journal of Eating Disorders|volume=40|issue=4|year=2007|pages=321–336|issn=02763478|doi=10.1002/eat.20372}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bulimia nervosa]]<ref name="ShapiroBerkman2007">{{cite journal|last1=Shapiro|first1=Jennifer R.|last2=Berkman|first2=Nancy D.|last3=Brownley|first3=Kimberly A.|last4=Sedway|first4=Jan A.|last5=Lohr|first5=Kathleen N.|last6=Bulik|first6=Cynthia M.|title=Bulimia nervosa treatment: A systematic review of randomized controlled trials|journal=International Journal of Eating Disorders|volume=40|issue=4|year=2007|pages=321–336|issn=02763478|doi=10.1002/eat.20372}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 446: | Line 446: | ||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | | align="center" style="background:#F5F5F5;" + |Nl to ↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | | align="center" style="background:#F5F5F5;" + |Nl to ↑ | ||
| align="center" style="background:#F5F5F5;" + |Clinical + lab | | align="center" style="background:#F5F5F5;" + |Clinical manifestations+ lab findings | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Profuse [[diarrhea]] | * Profuse [[diarrhea]] | ||
* [[Polyhydramnios]] | * [[Polyhydramnios]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Pyloric stenosis<ref name="BakalSarac2016">{{cite journal|last1=Bakal|first1=Unal|last2=Sarac|first2=Mehmet|last3=Aydin|first3=Mustafa|last4=Tartar|first4=Tugay|last5=Kazez|first5=Ahmet|title=Recent changes in the features of hypertrophic pyloric stenosis|journal=Pediatrics International|volume=58|issue=5|year=2016|pages=369–371|issn=13288067|doi=10.1111/ped.12860}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Pyloric stenosis]]<ref name="BakalSarac2016">{{cite journal|last1=Bakal|first1=Unal|last2=Sarac|first2=Mehmet|last3=Aydin|first3=Mustafa|last4=Tartar|first4=Tugay|last5=Kazez|first5=Ahmet|title=Recent changes in the features of hypertrophic pyloric stenosis|journal=Pediatrics International|volume=58|issue=5|year=2016|pages=369–371|issn=13288067|doi=10.1111/ped.12860}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 478: | Line 478: | ||
* Palpation of the “olive” | * Palpation of the “olive” | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Villous adenoma<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Villous adenoma]]<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 583: | Line 583: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Lab | | align="center" style="background:#F5F5F5;" + |Lab findings | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Chronic [[respiratory acidosis]] | * Chronic [[respiratory acidosis]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Hypomagnesemia<ref name="pmid9252977">{{cite journal |vauthors=Elisaf M, Milionis H, Siamopoulos KC |title=Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics |journal=Miner Electrolyte Metab |volume=23 |issue=2 |pages=105–12 |date=1997 |pmid=9252977 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypomagnesemia]]<ref name="pmid9252977">{{cite journal |vauthors=Elisaf M, Milionis H, Siamopoulos KC |title=Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics |journal=Miner Electrolyte Metab |volume=23 |issue=2 |pages=105–12 |date=1997 |pmid=9252977 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 610: | Line 610: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Lab | | align="center" style="background:#F5F5F5;" + |Lab findings | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Not applicable | * Not applicable | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Hypokalemia<ref name="pmid10665945">{{cite journal |vauthors=Galla JH |title=Metabolic alkalosis |journal=J. Am. Soc. Nephrol. |volume=11 |issue=2 |pages=369–75 |date=February 2000 |pmid=10665945 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypokalemia]]<ref name="pmid10665945">{{cite journal |vauthors=Galla JH |title=Metabolic alkalosis |journal=J. Am. Soc. Nephrol. |volume=11 |issue=2 |pages=369–75 |date=February 2000 |pmid=10665945 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 637: | Line 637: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Lab | | align="center" style="background:#F5F5F5;" + |Lab findings | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Not applicable | * Not applicable | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Bartter's syndrome<ref name="SimonKaret1996">{{cite journal|last1=Simon|first1=David B.|last2=Karet|first2=Fiona E.|last3=Hamdan|first3=Jahed M.|last4=Pietro|first4=Antonio Di|last5=Sanjad|first5=Sami A.|last6=Lifton|first6=Richard P.|title=Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2|journal=Nature Genetics|volume=13|issue=2|year=1996|pages=183–188|issn=1061-4036|doi=10.1038/ng0696-183}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bartter's syndrome]]<ref name="SimonKaret1996">{{cite journal|last1=Simon|first1=David B.|last2=Karet|first2=Fiona E.|last3=Hamdan|first3=Jahed M.|last4=Pietro|first4=Antonio Di|last5=Sanjad|first5=Sami A.|last6=Lifton|first6=Richard P.|title=Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2|journal=Nature Genetics|volume=13|issue=2|year=1996|pages=183–188|issn=1061-4036|doi=10.1038/ng0696-183}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 673: | Line 673: | ||
* [[Hypercalciuria]] | * [[Hypercalciuria]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Gitelman’s syndrome<ref name="FremontChan2012">{{cite journal|last1=Fremont|first1=Oliver T.|last2=Chan|first2=James C. M.|title=Understanding Bartter syndrome and Gitelman syndrome|journal=World Journal of Pediatrics|volume=8|issue=1|year=2012|pages=25–30|issn=1708-8569|doi=10.1007/s12519-012-0333-9}}</ref><ref name="pmid7700218">{{cite journal |vauthors=Colussi G, Macaluso M, Brunati C, Minetti L |title=Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome |journal=Miner Electrolyte Metab |volume=20 |issue=5 |pages=294–301 |date=1994 |pmid=7700218 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Gitelman syndrome|Gitelman’s syndrome]]<ref name="FremontChan2012">{{cite journal|last1=Fremont|first1=Oliver T.|last2=Chan|first2=James C. M.|title=Understanding Bartter syndrome and Gitelman syndrome|journal=World Journal of Pediatrics|volume=8|issue=1|year=2012|pages=25–30|issn=1708-8569|doi=10.1007/s12519-012-0333-9}}</ref><ref name="pmid7700218">{{cite journal |vauthors=Colussi G, Macaluso M, Brunati C, Minetti L |title=Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome |journal=Miner Electrolyte Metab |volume=20 |issue=5 |pages=294–301 |date=1994 |pmid=7700218 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 703: | Line 703: | ||
* [[Hypocalciuria]] | * [[Hypocalciuria]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Renal artery stenosis<ref name="SafianTextor2001">{{cite journal|last1=Safian|first1=Robert D.|last2=Textor|first2=Stephen C.|title=Renal-Artery Stenosis|journal=New England Journal of Medicine|volume=344|issue=6|year=2001|pages=431–442|issn=0028-4793|doi=10.1056/NEJM200102083440607}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal artery stenosis]]<ref name="SafianTextor2001">{{cite journal|last1=Safian|first1=Robert D.|last2=Textor|first2=Stephen C.|title=Renal-Artery Stenosis|journal=New England Journal of Medicine|volume=344|issue=6|year=2001|pages=431–442|issn=0028-4793|doi=10.1056/NEJM200102083440607}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 726: | Line 726: | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Clinical + imaging | | align="center" style="background:#F5F5F5;" + |Clinical manifestations+ imaging | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Chronic renal failure|Chronic kidney disease]] | * [[Chronic renal failure|Chronic kidney disease]] | ||
* Acute rise in [[Creatinine|Cr]] following [[ACE inhibitor|ACEIs]] or [[Angiotensin II receptor antagonist|ARBs]] | * Acute rise in [[Creatinine|Cr]] following [[ACE inhibitor|ACEIs]] or [[Angiotensin II receptor antagonist|ARBs]] | ||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Liddle syndrome<ref name="SalihGautschi2017">{{cite journal|last1=Salih|first1=Mahdi|last2=Gautschi|first2=Ivan|last3=van Bemmelen|first3=Miguel X.|last4=Di Benedetto|first4=Michael|last5=Brooks|first5=Alice S.|last6=Lugtenberg|first6=Dorien|last7=Schild|first7=Laurent|last8=Hoorn|first8=Ewout J.|title=A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome|journal=Journal of the American Society of Nephrology|volume=28|issue=11|year=2017|pages=3291–3299|issn=1046-6673|doi=10.1681/ASN.2016111163}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Liddle's syndrome|Liddle syndrome]]<ref name="SalihGautschi2017">{{cite journal|last1=Salih|first1=Mahdi|last2=Gautschi|first2=Ivan|last3=van Bemmelen|first3=Miguel X.|last4=Di Benedetto|first4=Michael|last5=Brooks|first5=Alice S.|last6=Lugtenberg|first6=Dorien|last7=Schild|first7=Laurent|last8=Hoorn|first8=Ewout J.|title=A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome|journal=Journal of the American Society of Nephrology|volume=28|issue=11|year=2017|pages=3291–3299|issn=1046-6673|doi=10.1681/ASN.2016111163}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 756: | Line 756: | ||
| align="center" style="background:#F5F5F5;" + |Genetic testing | | align="center" style="background:#F5F5F5;" + |Genetic testing | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Not applicable | |||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Renal tumors<ref name="LasseigneBrooks2018">{{cite journal|last1=Lasseigne|first1=Brittany N.|last2=Brooks|first2=James D.|title=The Role of DNA Methylation in Renal Cell Carcinoma|journal=Molecular Diagnosis & Therapy|year=2018|issn=1177-1062|doi=10.1007/s40291-018-0337-9}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal cell carcinoma|Renal tumors]]<ref name="LasseigneBrooks2018">{{cite journal|last1=Lasseigne|first1=Brittany N.|last2=Brooks|first2=James D.|title=The Role of DNA Methylation in Renal Cell Carcinoma|journal=Molecular Diagnosis & Therapy|year=2018|issn=1177-1062|doi=10.1007/s40291-018-0337-9}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 782: | Line 783: | ||
| align="center" style="background:#F5F5F5;" + |[[Biopsy]] | | align="center" style="background:#F5F5F5;" + |[[Biopsy]] | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Not applicable | |||
|- | |- | ||
! rowspan=" | ! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Cushing's syndrome<ref name="Araujo CastroMarazuela Azpiroz2018">{{cite journal|last1=Araujo Castro|first1=Marta|last2=Marazuela Azpiroz|first2=Mónica|title=Two types of ectopic Cushing syndrome or a continuum? Review|journal=Pituitary|year=2018|issn=1386-341X|doi=10.1007/s11102-018-0894-2}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cushing's syndrome]]<ref name="Araujo CastroMarazuela Azpiroz2018">{{cite journal|last1=Araujo Castro|first1=Marta|last2=Marazuela Azpiroz|first2=Mónica|title=Two types of ectopic Cushing syndrome or a continuum? Review|journal=Pituitary|year=2018|issn=1386-341X|doi=10.1007/s11102-018-0894-2}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 814: | Line 816: | ||
* [[Menstrual cycle|Menstrual]] changes | * [[Menstrual cycle|Menstrual]] changes | ||
|- | |- | ||
! rowspan="2" align="center" style="background:#DCDCDC;" + |Hyperaldosteronism | ! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperaldosteronism]] | ||
! align="center" style="background:#DCDCDC;" + |Primary<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Primary hyperaldosteronism|Primary]]<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 838: | Line 840: | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Lab | | align="center" style="background:#F5F5F5;" + |Lab findings | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Resistant [[Hypertension|HTN]] | * Resistant [[Hypertension|HTN]] | ||
| Line 844: | Line 846: | ||
* Bilateral [[adrenal hyperplasia]] | * Bilateral [[adrenal hyperplasia]] | ||
|- | |- | ||
! align="center" style="background:#DCDCDC;" + |Secondary<ref name="pmid29758100">{{cite journal |vauthors=Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P |title=Diagnostic approach to low renin hypertension |journal=Clin. Endocrinol. (Oxf) |volume= |issue= |pages= |date=May 2018 |pmid=29758100 |doi=10.1111/cen.13741 |url=}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Secondary hyperaldosteronism|Secondary]]<ref name="pmid29758100">{{cite journal |vauthors=Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P |title=Diagnostic approach to low renin hypertension |journal=Clin. Endocrinol. (Oxf) |volume= |issue= |pages= |date=May 2018 |pmid=29758100 |doi=10.1111/cen.13741 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 867: | Line 869: | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Lab | | align="center" style="background:#F5F5F5;" + |Lab findings | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Renin-producing tumors|Renin−producing tumor]] | * [[Renin-producing tumors|Renin−producing tumor]] | ||
| Line 875: | Line 877: | ||
* [[Cirrhosis]] with [[ascites]] | * [[Cirrhosis]] with [[ascites]] | ||
|- | |- | ||
! rowspan="2" align="center" style="background:#DCDCDC;" + | | ! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Congenital adrenal hyperplasia]] | ||
! align="center" style="background:#DCDCDC;" + |11β−Hydroxylase deficiency | ! align="center" style="background:#DCDCDC;" + |[[11β-hydroxylase deficiency|11β−Hydroxylase deficiency]]<ref name="pmid29626607">{{cite journal |vauthors=Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F |title=Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene |journal=J. Steroid Biochem. Mol. Biol. |volume= |issue= |pages= |date=April 2018 |pmid=29626607 |doi=10.1016/j.jsbmb.2018.04.001 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 896: | Line 898: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |↓ | | align="center" style="background:#F5F5F5;" + |↓ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Genetic testing | |||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Virilization]] | |||
* [[Hyperpigmentation|Skin hyperpigmentation]] | |||
* Bilateral [[adrenal gland]] enlargement | |||
|- | |- | ||
! align="center" style="background:#DCDCDC;" + |17α−Hydroxylase deficiency | ! align="center" style="background:#DCDCDC;" + |[[17 alpha-hydroxylase deficiency|17α−Hydroxylase deficiency]]<ref name="GoldsmithSolomon1967">{{cite journal|last1=Goldsmith|first1=Oliver|last2=Solomon|first2=David H.|last3=Horton|first3=Richard|title=Hypogonadism and Mineralocorticoid Excess|journal=New England Journal of Medicine|volume=277|issue=13|year=1967|pages=673–677|issn=0028-4793|doi=10.1056/NEJM196709282771302}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| Line 922: | Line 927: | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |↓ | | align="center" style="background:#F5F5F5;" + |↓ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Genetic testing | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Intersexuality|Ambiguous genitalia]] | |||
* [[Undescended testes]] | |||
* Lacks [[Secondary sexual characteristic|2° sexual development]] | |||
* [[Hyperpigmentation|Skin hyperpigmentation]] | |||
* Bilateral [[adrenal gland]] enlargement | |||
|- | |- | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Cystic | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cystic fibrosis]]<ref name="pmid9048354">{{cite journal |vauthors=Bates CM, Baum M, Quigley R |title=Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent |journal=J. Am. Soc. Nephrol. |volume=8 |issue=2 |pages=352–5 |date=February 1997 |pmid=9048354 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| Line 961: | Line 945: | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| Line 971: | Line 955: | ||
| align="center" style="background:#F5F5F5;" + |↓ | | align="center" style="background:#F5F5F5;" + |↓ | ||
| align="center" style="background:#F5F5F5;" + |↓ | | align="center" style="background:#F5F5F5;" + |↓ | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| Line 977: | Line 961: | ||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | | align="center" style="background:#F5F5F5;" + |Nl to ↑ | ||
| align="center" style="background:#F5F5F5;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + |Genetic testing | | align="center" style="background:#F5F5F5;" + |Genetic testing | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Fatigue]] | |||
* Persistent pulmonary [[infection]] | |||
* [[Pancreatic insufficiency]] | |||
|- | |- | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ||
| Line 1,011: | Line 998: | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Medicine]] | |||
[[Category:Nephrology]] | |||
[[Category:Up-To-Date]] | |||
[[Category: | |||
Latest revision as of 22:43, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Metabolic alkalosis might be consequence of several conditions such as exogenous HCO3− loads, medications and poisoning, gastrointestinal, renal, endocrine, and systemic diseases.
Metabolic Alkalosis
Differential diagnosis of metabolic alkalosis is as follow:
| Category | Disease | Mechanism | Clinical | Paraclinical | Gold standard diagnosis | Other findings | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Signs | Lab data | ||||||||||||||||||||||||
| ABG | Chemistry | Enzyme | Renal function | |||||||||||||||||||||||
| Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | |||||
| Exogenous HCO3− loads | Acute alkali administration[1] | − | + | − | − | − | + | − | + | ↓ | − | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl | Nl | ↑ | ↑ | Nl | Clinical manifestations |
| |
| Milk−alkali syndrome[2] | − | + | − | + | − | + | − | + | ↓ | + | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | ↓ | ↑ | ↑ | ↑ | Nl | Clinical manifestationsk + exclusion of other causes of hypercalcemia |
| ||
| Transfusion[3] | − | + | − | − | ± | ± | − | + | ↓ | − | ↑ | ↑ | ↓ | ↓ | ↓/↑ | ↓ | ↓ | ↑ | ↑ | Nl to ↑ | Nl to ↑ | Nl | History of administration of large quantities of blood products that contain sodium citrate |
| ||
| Drugs/Medication | Chloruretic diuretics[4] | + | − | + | + | − | − | − | − | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | ↑ | History of diuretic use | ||
| Penicillin[5] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | Nl | Nl | Nl | History of penicillin use |
| ||
| Licorice[6][7] | + | − | − | + | − | − | − | + | Nl to ↑ | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | Clinical manifestations | |||
| Laxative abuse[8] | + | − | + | − | − | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | ↑ | Nl to ↑ | Nl | ↓ | High level of suspicion |
| ||
| Antacids[9][10] |
|
+ | + | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | Nl | Nl to ↑ | Nl to ↑ | Nl | Clinical manifestations |
| |
| Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |
| Gastrointestinal origin | Vomiting[11] | + | − | + | − | ± | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical manifestations |
| |
| Nasogastric tube suction[12] | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical manifestations | |||
| Zollinger−Ellison syndrome[13] | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Serum gastrin concentration + secretin stimulation test |
| ||
| Bulimia nervosa[14] | + | − | + | − | − | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | Nl | ↓ | ↑ | Nl to ↑ | Nl | ↓ | High level of suspicion |
| ||
| Congenital chloridorrhea[15] | + | − | + | − | − | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl to ↑ | Nl to ↑ | Nl to ↑ | Clinical manifestations+ lab findings |
| ||
| Pyloric stenosis[16] | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Physical exam + imaging |
| ||
| Villous adenoma[17] | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl to ↑ | Nl | ↑ | Colonoscopy | |||
| Gastrocystoplasty[18] | − | − | + | − | − | − | + | − | ↓ | − | ↑ | ↑ | Nl | ↓ | Nl | Nl | Nl | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | History of operation | |||
| Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |
| Renal origin | Posthypercapnic state[19] | − | − | + | + | − | ± | − | − | Nl | − | ↑ | ↑↑ | ↓ | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab findings |
| |
| Hypomagnesemia[20] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab findings |
| ||
| Hypokalemia[21] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab findings |
| ||
| Bartter's syndrome[22] | + | − | − | + | − | − | − | − | Nl | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | ↓ | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | Genetic testing | |||
| Gitelman’s syndrome[23][24] | + | − | − | + | − | − | − | − | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl | Genetic testing |
| ||
| Renal artery stenosis[25] | + | − | + | − | − | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | Clinical manifestations+ imaging |
| ||
| Liddle syndrome[26] | + | − | − | + | − | − | − | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl | Genetic testing |
| ||
| Renal tumors[27] | + | − | + | − | − | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | Biopsy |
| ||
| Endocrine | Cushing's syndrome[28] | + | − | + | − | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↑ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | 24−hour urinary cortisol excretion + low−dose dexamethasone suppression test | ||
| Hyperaldosteronism | Primary[29] | + | − | + | − | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | Nl to ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | Lab findings |
| |
| Secondary[30] | + | − | + | − | − | + | + | + | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | ↑ | Nl | Lab findings |
| ||
| Congenital adrenal hyperplasia | 11β−Hydroxylase deficiency[31] | − | − | − | + | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | Nl | Nl | Nl | Genetic testing |
| |
| 17α−Hydroxylase deficiency[32] | − | − | − | + | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | Nl | Nl | Nl | Genetic testing |
| ||
| Systemic | Cystic fibrosis[33] | + | − | + | − | − | + | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | Nl | Nl | Nl | ↑ | Nl to ↑ | Nl | ↑ | Genetic testing |
| |
| Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |
References
- ↑ Máttar, João A.; Weil, Max Harry; Shubin, Herbert; Stein, Leon (1974). "Cardiac arrest in the critically III". The American Journal of Medicine. 56 (2): 162–168. doi:10.1016/0002-9343(74)90593-2. ISSN 0002-9343.
- ↑ Abreo, Kenneth (1993). "The Milk-Alkali Syndrome". Archives of Internal Medicine. 153 (8): 1005. doi:10.1001/archinte.1993.00410080065011. ISSN 0003-9926.
- ↑ Gupta M, Wadhwa NK, Bukovsky R (January 2004). "Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate". Am. J. Kidney Dis. 43 (1): 67–73. PMID 14712429.
- ↑ Luke, R. G.; Galla, J. H. (2012). "It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis". Journal of the American Society of Nephrology. 23 (2): 204–207. doi:10.1681/ASN.2011070720. ISSN 1046-6673.
- ↑ Zaki, SyedAhmed; Lad, Vijay (2011). "Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis". Indian Journal of Pharmacology. 43 (5): 609. doi:10.4103/0253-7613.84986. ISSN 0253-7613.
- ↑ Meltem, Akkas Camkurt; Figen, Coskun; Nalan, Metin Aksu; Mahir, Kunt; Sebnem, Bozkurt; Mehlika, Isildak; Kasim, Kilic Ahmet; Miyase, Bayraktar (2009). "A hypokalemic muscular weakness after licorice ingestion: a case report". Cases Journal. 2 (1): 8053. doi:10.4076/1757-1626-2-8053. ISSN 1757-1626.
- ↑ Lin, Shih-Hua; Yang, Sung-Sen; Chau, Tom; Halperin, Mitchell L. (2003). "An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion". The American Journal of the Medical Sciences. 325 (3): 153–156. doi:10.1097/00000441-200303000-00008. ISSN 0002-9629.
- ↑ Roerig, James L.; Steffen, Kristine J.; Mitchell, James E.; Zunker, Christie (2010). "Laxative Abuse". Drugs. 70 (12): 1487–1503. doi:10.2165/11898640-000000000-00000. ISSN 0012-6667.
- ↑ Sahani, Mandeep M.; Brennan, John F.; Nwakanma, Chukwuemeka; Chow, May T.; Ing, Todd S.; Leehey, David J. (2001). "Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication". Artificial Organs. 25 (4): 313–315. doi:10.1046/j.1525-1594.2001.06714.x. ISSN 0160-564X.
- ↑ Vanpee, Dominique; Delgrange, Etienne; Gillet, Jean-Bernard; Donckier, Julian (2000). "Ingestion of antacid tablets (Rennie®) and acute confusion". The Journal of Emergency Medicine. 19 (2): 169–171. doi:10.1016/S0736-4679(00)00206-7. ISSN 0736-4679.
- ↑ Gan, Tong J.; Meyer, Tricia; Apfel, Christian C.; Chung, Frances; Davis, Peter J.; Eubanks, Steve; Kovac, Anthony; Philip, Beverly K.; Sessler, Daniel I.; Temo, James; Tram??r, Martin R.; Watcha, Mehernoor (2003). "Consensus Guidelines for Managing Postoperative Nausea and Vomiting". Anesthesia & Analgesia: 62–71. doi:10.1213/01.ANE.0000068580.00245.95. ISSN 0003-2999.
- ↑ Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere (2011). "Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement". Journal of Parenteral and Enteral Nutrition. 35 (4): 540–544. doi:10.1177/0148607110383285. ISSN 0148-6071.
- ↑ Hung, Patrick D.; Schubert, Mitchell L.; Mihas, Anastasios A. (2003). "Zollinger-Ellison syndrome". Current Treatment Options in Gastroenterology. 6 (2): 163–170. doi:10.1007/s11938-003-0017-6. ISSN 1092-8472.
- ↑ Shapiro, Jennifer R.; Berkman, Nancy D.; Brownley, Kimberly A.; Sedway, Jan A.; Lohr, Kathleen N.; Bulik, Cynthia M. (2007). "Bulimia nervosa treatment: A systematic review of randomized controlled trials". International Journal of Eating Disorders. 40 (4): 321–336. doi:10.1002/eat.20372. ISSN 0276-3478.
- ↑ Wedenoja, S.; HãGlund, P.; Holmberg, C. (2010). "Review article: the clinical management of congenital chloride diarrhoea". Alimentary Pharmacology & Therapeutics. 31 (4): 477–485. doi:10.1111/j.1365-2036.2009.04197.x. ISSN 0269-2813. C1 control character in
|last2=at position 3 (help) - ↑ Bakal, Unal; Sarac, Mehmet; Aydin, Mustafa; Tartar, Tugay; Kazez, Ahmet (2016). "Recent changes in the features of hypertrophic pyloric stenosis". Pediatrics International. 58 (5): 369–371. doi:10.1111/ped.12860. ISSN 1328-8067.
- ↑ Gennari, F. J.; Weise, W. J. (2008). "Acid-Base Disturbances in Gastrointestinal Disease". Clinical Journal of the American Society of Nephrology. 3 (6): 1861–1868. doi:10.2215/CJN.02450508. ISSN 1555-9041.
- ↑ Kurzrock, Eric A.; Baskin, Laurence S.; Kogan, Barry A. (1998). "GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP". The Journal of Urology. 160 (6): 2182–2186. doi:10.1016/S0022-5347(01)62289-4. ISSN 0022-5347.
- ↑ Banga, Amit; Khilnani, G. C. (2009). "Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay". COPD: Journal of Chronic Obstructive Pulmonary Disease. 6 (6): 437–440. doi:10.3109/15412550903341448. ISSN 1541-2555.
- ↑ Elisaf M, Milionis H, Siamopoulos KC (1997). "Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics". Miner Electrolyte Metab. 23 (2): 105–12. PMID 9252977.
- ↑ Galla JH (February 2000). "Metabolic alkalosis". J. Am. Soc. Nephrol. 11 (2): 369–75. PMID 10665945.
- ↑ Simon, David B.; Karet, Fiona E.; Hamdan, Jahed M.; Pietro, Antonio Di; Sanjad, Sami A.; Lifton, Richard P. (1996). "Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2". Nature Genetics. 13 (2): 183–188. doi:10.1038/ng0696-183. ISSN 1061-4036.
- ↑ Fremont, Oliver T.; Chan, James C. M. (2012). "Understanding Bartter syndrome and Gitelman syndrome". World Journal of Pediatrics. 8 (1): 25–30. doi:10.1007/s12519-012-0333-9. ISSN 1708-8569.
- ↑ Colussi G, Macaluso M, Brunati C, Minetti L (1994). "Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome". Miner Electrolyte Metab. 20 (5): 294–301. PMID 7700218.
- ↑ Safian, Robert D.; Textor, Stephen C. (2001). "Renal-Artery Stenosis". New England Journal of Medicine. 344 (6): 431–442. doi:10.1056/NEJM200102083440607. ISSN 0028-4793.
- ↑ Salih, Mahdi; Gautschi, Ivan; van Bemmelen, Miguel X.; Di Benedetto, Michael; Brooks, Alice S.; Lugtenberg, Dorien; Schild, Laurent; Hoorn, Ewout J. (2017). "A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome". Journal of the American Society of Nephrology. 28 (11): 3291–3299. doi:10.1681/ASN.2016111163. ISSN 1046-6673.
- ↑ Lasseigne, Brittany N.; Brooks, James D. (2018). "The Role of DNA Methylation in Renal Cell Carcinoma". Molecular Diagnosis & Therapy. doi:10.1007/s40291-018-0337-9. ISSN 1177-1062.
- ↑ Araujo Castro, Marta; Marazuela Azpiroz, Mónica (2018). "Two types of ectopic Cushing syndrome or a continuum? Review". Pituitary. doi:10.1007/s11102-018-0894-2. ISSN 1386-341X.
- ↑ Martell-Claros, Nieves; Abad-Cardiel, María; Alvarez-Alvarez, Beatriz; García-Donaire, José A.; Pérez, Cristina Fernández (2015). "Primary aldosteronism and its various clinical scenarios". Journal of Hypertension. 33 (6): 1226–1232. doi:10.1097/HJH.0000000000000546. ISSN 0263-6352.
- ↑ Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P (May 2018). "Diagnostic approach to low renin hypertension". Clin. Endocrinol. (Oxf). doi:10.1111/cen.13741. PMID 29758100.
- ↑ Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F (April 2018). "Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene". J. Steroid Biochem. Mol. Biol. doi:10.1016/j.jsbmb.2018.04.001. PMID 29626607.
- ↑ Goldsmith, Oliver; Solomon, David H.; Horton, Richard (1967). "Hypogonadism and Mineralocorticoid Excess". New England Journal of Medicine. 277 (13): 673–677. doi:10.1056/NEJM196709282771302. ISSN 0028-4793.
- ↑ Bates CM, Baum M, Quigley R (February 1997). "Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent". J. Am. Soc. Nephrol. 8 (2): 352–5. PMID 9048354.