Hypokalemia differential diagnosis: Difference between revisions

Latest revision as of 22:47, 14 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Potassium is one of the intracellular cation. Any derangement of potassium serum levels can disturb the transmembrane potential and renders excitable cells (nerve and muscle) hyperpolarized and less excitable. However, cardiac cells don't obey this rule and become hyperexcitable. Potassium regulation is essential to maintain a normal activity in cells. Any imparment in potassium serum levels will have severe consequences on several organs especially the heart and the nervous system.

Differentiating Causes of Hypokalemia

Differentiating the diseases that can cause hypokalemia is as following table:

Diseases		Clinical manifestations								Para−clinical findings							Gold standard	Additional findings
		Symptoms					Physical examination			Para−clinical findings
		Symptoms					Physical examination			Lab Findings					Imaging
		Fatigue	Fever	Urinary symptoms			Blood Pressure	Skin lesions	Edema	ABG	Urinalysis	Transtubular potassium gradient	Urine Potassium:Creatinine	Other	Ultrasonography	CT scan
		Fatigue	Fever	Polyuria	Oliguria	Nocturia	Blood Pressure	Skin lesions	Edema	ABG	Urinalysis	Transtubular potassium gradient	Urine Potassium:Creatinine	Other	Ultrasonography	CT scan
Renal and adrenal disorders	Loop diuretic use^[1]	+/−	−	+	−	+/−	↓	−	+	Metabolic alkalosis	↑K⁺	> 7	>20mEq/g	↑Na⁺	−	−	History of medication use	−
	Primary hyperaldosteronism^[2]	+	−	+	−	+	↑	Facial flushing	−	Metabolic alkalosis	↑K⁺, ↓Na⁺			↓PRA, ↑PAC, ↓Na⁺	Unilateral adrenal hyperplasia	Hypodense unilateral adrenal macroadenoma (>1 cm)	PAC:PRA ratio	Mood disturbance, paresthesia, muscle cramps
	Cushing syndrome^[3]	+	+/−	+/−	−	−	↑	Facial plethora, purple striae	+	Metabolic alkalosis	Glucosuria			↑BS	Unilateral adrenal hyperplasia	−	Urinary free cortisol (24−hour)	Dorsicocervical fat pad, obesity, hirsutism
	Hemodialysis^[4]	+/−	+/−	+/−	−	−	Normal	Pustular lesions	−	Metabolic alkalosis	Normal			↓Na⁺	−	−	History	Carpal tunnel syndrome
	Bartter syndrome^[5]	+	−	+	−	+/−	Normal or ↓	−	−	Metabolic alkalosis	↑K⁺, ↑Ca⁺², ↑Cl^-			−	−	−	Laboratory findings	Mental retardation, sensorineural hearing loss
	Gitelman syndrome^[6]	+	−	+	−	+	Normal	−	−	Metabolic alkalosis	↑K⁺, ↓Ca⁺², ↑Cl^-			−	−	−	Laboratory findings	Growth retardation, tetany, muscle cramp
	Liddle syndrome^[7]	−	−	+/−	−	−	↑	−	+/−	Metabolic alkalosis	↑K⁺, ↓Na⁺			↓PRA, ↓PAC	−	−	Laboratory findings	Pseudohyperaldosteronism
Gastrointestinal disorders	GI bleeding^[8]	+	−	−	+	−	↓	−	−	Normal	Normal	< 3	< 20 mEq/g	Anemia	−	−	Laboratory findings	Orthostatic hypotension, bradycardia
	Vomiting^[9]	+	−	−	+	−	↓	−	−	Metabolic alkalosis	Cl^- <20 mEq/L			−	−	−	Laboratory findings	Dry mucous membranes, lethargy
	Severe diarrhea^[10]	+	−	−	+	−	↓	−	−	Metabolic alkalosis	K⁺<20 mEq/L			−	−	−	Laboratory findings	Dry mucous membranes, lethargy
	Villous adenoma^[11]	+	−	−	+	−	↓	−	−	Normal	K⁺ and Cl^- <20 mEq/L			Anemia	−	−	Colonoscopy	Hematochezia
	VIPoma^[12]	+	+/−	−	+	−	↓	Facial flushing, skin rash	+	Normal	K⁺<20 mEq/L			Stool osmolar gap <50 mOsm/kg	Endoscopic ultrasound for VIPomas of 2−3 mm	Pancreatic VIPomas >3 cm	Laboratory findings	Weight loss
Neuropsychiatric disorders	Primary polydipsia^[13]	−	−	+	−	+	Normal	−	+/−	Normal	↓Urine osmolarity			↓Na⁺	−	−	Water restriction test	Psychosis
	Central diabetes insipidus^[14]	+	−	+	−	+	Normal or ↓	−	−	Normal	↓Urine osmolarity			↑Na⁺	−	−	Water restriction test	Ischemic encephalopathy
	Bulimia nervosa^[15]	−	−	−	+/−	−	Normal or ↓	Asteatotic skin Carotenodermia	−	Normal	↑K⁺, ↓Cl^-			−	−	−	Psychological interview	Parotid gland enlargement, lanugo−like hair
	Anorexia nervosa^[16]	+	−	−	+/−	−	↓	Xerosis, hair effluvium	−	Normal	↑K⁺, ↓Cl^-			−	−	−	Psychological interview	Orthostatic hypotension, bradycardia
	Hypokalemic periodic paralysis^[17]	+	−	−	−	+/−	Normal or ↓	−	+/−	Metabolic alkalosis	K⁺<20 mEq/L			Thyrotoxicosis, ↓Mg⁺, ↓PO₄^-3	−	−	Laboratory findings	Paralytic episodes, arrhythmias
Systemic diseases	Hypothermia^[18]	−	−	−	+/−	−	Normal	Frostbite	−	Normal	Normal			−	−	−	Clinical findings	Impaired mental state
	Alcoholism^[19]	+	+/−	+	−	+	Normal or ↓	Icterus, caput medusae	+	Metabolic alkalosis	Ketonuria			Anemia	−	−	Clinical findings	Digital clubbing, gynecomastia
	Diabetic ketoacidosis^[20]	+	+/−	+	−	+	↓	Xerosis	−	Metabolic acidosis	Ketonuria			↑Serum ketone, ↑ blood glucose	−	−	Laboratory findings	Dry mucous membranes, shock
	Hypomagnesemia^[21]	+	−	−	+/−	−	Normal	−	+/−	Metabolic alkalosis	−			↓Ca⁺²	−	−	Laboratory findings	Trousseau and Chvostek signs
	Burns^[22]	+/−	−	−	+	−	↓	Vesicle and bullae, erythema	+	Normal	−			Acute phase reactant	−	−	Clinical findings	Dehydration
	Cystic fibrosis^[23]	+/−	+/−	−	+/−	−	↓	Early aquagenic skin wrinkling	+/−	Normal	−			−	-	Pulmonary infiltration	Sweat chloride test	Pancreatic insufficiency

References

↑ Bourke E, Delaney V (1994). "Prevention of hypokalemia caused by diuretics". Heart Dis Stroke. 3 (2): 63–7. PMID 8199766.
↑ Wu C, Xin J, Xin M, Zou H, Jing L, Zhu C; et al. (2016). "Hypokalemic myopathy in primary aldosteronism: A case report". Exp Ther Med. 12 (6): 4064–4066. doi:10.3892/etm.2016.3864. PMC 5228118. PMID 28101185.
↑ Torpy DJ, Mullen N, Ilias I, Nieman LK (September 2002). "Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases". Ann. N. Y. Acad. Sci. 970: 134–44. PMID 12381548.
↑ Choi HY, Ha SK (2013). "Potassium balances in maintenance hemodialysis". Electrolyte Blood Press. 11 (1): 9–16. doi:10.5049/EBP.2013.11.1.9. PMC 3741441. PMID 23946760.
↑ Hebert SC (September 2003). "Bartter syndrome". Curr. Opin. Nephrol. Hypertens. 12 (5): 527–32. doi:10.1097/01.mnh.0000088732.87142.43. PMID 12920401.
↑ Knoers NV, Levtchenko EN (2008). "Gitelman syndrome". Orphanet J Rare Dis. 3: 22. doi:10.1186/1750-1172-3-22. PMC 2518128. PMID 18667063.
↑ Tetti M, Monticone S, Burrello J, Matarazzo P, Veglio F, Pasini B, Jeunemaitre X, Mulatero P (March 2018). "Liddle Syndrome: Review of the Literature and Description of a New Case". Int J Mol Sci. 19 (3). doi:10.3390/ijms19030812. PMC 5877673. PMID 29534496.
↑ Asmar A, Mohandas R, Wingo CS (2012). "A physiologic-based approach to the treatment of a patient with hypokalemia". Am J Kidney Dis. 60 (3): 492–7. doi:10.1053/j.ajkd.2012.01.031. PMC 4776048. PMID 22901631.
↑ Cheungpasitporn W, Suksaranjit P, Chanprasert S (February 2012). "Pathophysiology of vomiting-induced hypokalemia and diagnostic approach". Am J Emerg Med. 30 (2): 384. doi:10.1016/j.ajem.2011.10.005. PMID 22169581.
↑ Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M (November 2017). "Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature". Neurogastroenterol. Motil. 29 (11). doi:10.1111/nmo.13120. PMID 28580600.
↑ Sanchez Garcia S, Villarejo Campos P, Manzanares Campillo Mdel C, Gil Rendo A, Muñoz Atienza V, García Santos EP; et al. (2013). "Hypersecretory villous adenoma as the primary cause of an intestinal intussusception and McKittrick-Wheelock syndrome". Can J Gastroenterol. 27 (11): 621–2. PMC 3816940. PMID 24199207.
↑ Krejs GJ (May 1987). "VIPoma syndrome". Am. J. Med. 82 (5B): 37–48. PMID 3035922.
↑ Gill M, McCauley M (2015). "Psychogenic polydipsia: the result, or cause of, deteriorating psychotic symptoms? A case report of the consequences of water intoxication". Case Rep Psychiatry. 2015: 846459. doi:10.1155/2015/846459. PMC 4320790. PMID 25688318.
↑ Nguyen FN, Kar JK, Verduzco-Gutierrez M, Zakaria A (2014). "A case of hypokalemic paralysis in a patient with neurogenic diabetes insipidus". Neurohospitalist. 4 (2): 90–3. doi:10.1177/1941874413495702. PMC 3975788. PMID 24707338.
↑ Rushing JM, Jones LE, Carney CP (2003). "Bulimia Nervosa: A Primary Care Review". Prim Care Companion J Clin Psychiatry. 5 (5): 217–224. PMC 419300. PMID 15213788.
↑ Liang CC, Yeh HC (2011). "Hypokalemic nephropathy in anorexia nervosa". CMAJ. 183 (11): E761. doi:10.1503/cmaj.101790. PMC 3153553. PMID 21670105.
↑ "Hypokalemic periodic paralysis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program".
↑ Zydlewski AW, Hasbargen JA (October 1998). "Hypothermia-induced hypokalemia". Mil Med. 163 (10): 719–21. PMID 9795553.
↑ Elisaf M, Liberopoulos E, Bairaktari E, Siamopoulos K (March 2002). "Hypokalaemia in alcoholic patients". Drug Alcohol Rev. 21 (1): 73–6. doi:10.1080/09595230220119282. PMID 12189007.
↑ Davis SM, Maddux AB, Alonso GT, Okada CR, Mourani PM, Maahs DM (2016). "Profound hypokalemia associated with severe diabetic ketoacidosis". Pediatr Diabetes. 17 (1): 61–5. doi:10.1111/pedi.12246. PMC 4896141. PMID 25430801.
↑ Huang CL, Kuo E (October 2007). "Mechanism of hypokalemia in magnesium deficiency". J. Am. Soc. Nephrol. 18 (10): 2649–52. doi:10.1681/ASN.2007070792. PMID 17804670.
↑ Nielson CB, Duethman NC, Howard JM, Moncure M, Wood JG (2017). "Burns: Pathophysiology of Systemic Complications and Current Management". J Burn Care Res. 38 (1): e469–e481. doi:10.1097/BCR.0000000000000355. PMC 5214064. PMID 27183443.
↑ 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.

Template:WH Template:WS

[pmid8199766-1] Bourke E, Delaney V (1994). "Prevention of hypokalemia caused by diuretics". Heart Dis Stroke. 3 (2): 63–7. PMID 8199766.

[pmid28101185-2] Wu C, Xin J, Xin M, Zou H, Jing L, Zhu C; et al. (2016). "Hypokalemic myopathy in primary aldosteronism: A case report". Exp Ther Med. 12 (6): 4064–4066. doi:10.3892/etm.2016.3864. PMC 5228118. PMID 28101185.

[pmid12381548-3] Torpy DJ, Mullen N, Ilias I, Nieman LK (September 2002). "Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases". Ann. N. Y. Acad. Sci. 970: 134–44. PMID 12381548.

[pmid23946760-4] Choi HY, Ha SK (2013). "Potassium balances in maintenance hemodialysis". Electrolyte Blood Press. 11 (1): 9–16. doi:10.5049/EBP.2013.11.1.9. PMC 3741441. PMID 23946760.

[pmid12920401-5] Hebert SC (September 2003). "Bartter syndrome". Curr. Opin. Nephrol. Hypertens. 12 (5): 527–32. doi:10.1097/01.mnh.0000088732.87142.43. PMID 12920401.

[pmid18667063-6] Knoers NV, Levtchenko EN (2008). "Gitelman syndrome". Orphanet J Rare Dis. 3: 22. doi:10.1186/1750-1172-3-22. PMC 2518128. PMID 18667063.

[pmid29534496-7] Tetti M, Monticone S, Burrello J, Matarazzo P, Veglio F, Pasini B, Jeunemaitre X, Mulatero P (March 2018). "Liddle Syndrome: Review of the Literature and Description of a New Case". Int J Mol Sci. 19 (3). doi:10.3390/ijms19030812. PMC 5877673. PMID 29534496.

[pmid22901631-8] Asmar A, Mohandas R, Wingo CS (2012). "A physiologic-based approach to the treatment of a patient with hypokalemia". Am J Kidney Dis. 60 (3): 492–7. doi:10.1053/j.ajkd.2012.01.031. PMC 4776048. PMID 22901631.

[pmid22169581-9] Cheungpasitporn W, Suksaranjit P, Chanprasert S (February 2012). "Pathophysiology of vomiting-induced hypokalemia and diagnostic approach". Am J Emerg Med. 30 (2): 384. doi:10.1016/j.ajem.2011.10.005. PMID 22169581.

[pmid28580600-10] Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M (November 2017). "Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature". Neurogastroenterol. Motil. 29 (11). doi:10.1111/nmo.13120. PMID 28580600.

[pmid24199207-11] Sanchez Garcia S, Villarejo Campos P, Manzanares Campillo Mdel C, Gil Rendo A, Muñoz Atienza V, García Santos EP; et al. (2013). "Hypersecretory villous adenoma as the primary cause of an intestinal intussusception and McKittrick-Wheelock syndrome". Can J Gastroenterol. 27 (11): 621–2. PMC 3816940. PMID 24199207.

[pmid3035922-12] Krejs GJ (May 1987). "VIPoma syndrome". Am. J. Med. 82 (5B): 37–48. PMID 3035922.

[pmid25688318-13] Gill M, McCauley M (2015). "Psychogenic polydipsia: the result, or cause of, deteriorating psychotic symptoms? A case report of the consequences of water intoxication". Case Rep Psychiatry. 2015: 846459. doi:10.1155/2015/846459. PMC 4320790. PMID 25688318.

[pmid24707338-14] Nguyen FN, Kar JK, Verduzco-Gutierrez M, Zakaria A (2014). "A case of hypokalemic paralysis in a patient with neurogenic diabetes insipidus". Neurohospitalist. 4 (2): 90–3. doi:10.1177/1941874413495702. PMC 3975788. PMID 24707338.

[pmid15213788-15] Rushing JM, Jones LE, Carney CP (2003). "Bulimia Nervosa: A Primary Care Review". Prim Care Companion J Clin Psychiatry. 5 (5): 217–224. PMC 419300. PMID 15213788.

[pmid21670105-16] Liang CC, Yeh HC (2011). "Hypokalemic nephropathy in anorexia nervosa". CMAJ. 183 (11): E761. doi:10.1503/cmaj.101790. PMC 3153553. PMID 21670105.

[urlHypokalemic_periodic_paralysis_|_Genetic_and_Rare_Diseases_Information_Center_(GARD)_–_an_NCATS_Program-17] "Hypokalemic periodic paralysis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program".

[pmid9795553-18] Zydlewski AW, Hasbargen JA (October 1998). "Hypothermia-induced hypokalemia". Mil Med. 163 (10): 719–21. PMID 9795553.

[pmid12189007-19] Elisaf M, Liberopoulos E, Bairaktari E, Siamopoulos K (March 2002). "Hypokalaemia in alcoholic patients". Drug Alcohol Rev. 21 (1): 73–6. doi:10.1080/09595230220119282. PMID 12189007.

[pmid25430801-20] Davis SM, Maddux AB, Alonso GT, Okada CR, Mourani PM, Maahs DM (2016). "Profound hypokalemia associated with severe diabetic ketoacidosis". Pediatr Diabetes. 17 (1): 61–5. doi:10.1111/pedi.12246. PMC 4896141. PMID 25430801.

[pmid17804670-21] Huang CL, Kuo E (October 2007). "Mechanism of hypokalemia in magnesium deficiency". J. Am. Soc. Nephrol. 18 (10): 2649–52. doi:10.1681/ASN.2007070792. PMID 17804670.

[pmid27183443-22] Nielson CB, Duethman NC, Howard JM, Moncure M, Wood JG (2017). "Burns: Pathophysiology of Systemic Complications and Current Management". J Burn Care Res. 38 (1): e469–e481. doi:10.1097/BCR.0000000000000355. PMC 5214064. PMID 27183443.

[pmid9048354-23] 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.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Hypokalemia}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Hypokalemia]]
-{{CMG}}
+{{CMG}}; {{AE}}{{EG}}
-Hypokalemia must be differentiated from other causes of diabetes insipidus.
+== Overview ==
+[[Potassium]] is one of the [[intracellular]] [[cation]]. Any derangement of potassium serum levels can disturb the transmembrane [[potential]] and renders excitable cells ([[nerve]] and [[muscle]]) [[Hyperpolarization (biology)|hyperpolariz]]<nowiki/>ed and less excitable. However, [[Cardiac|cardiac cells]] don't obey this rule and become hyperexcitable. [[Potassium]] regulation is essential to maintain a normal activity in cells. Any imparment in potassium serum levels will have severe consequences on several organs especially the [[heart]] and the [[nervous system]].
+== Differentiating Causes of Hypokalemia ==
+=== Differentiating the diseases that can cause hypokalemia is as following table: ===
+<small><small>
 {| class="wikitable"
-!Type of DI
+|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!Subclass
+! colspan="2" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
-!Disease
+! colspan="8" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
-!Defining signs and symptoms
+! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para−clinical findings
-!Lab/Imaging findings
+! colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
+! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
+|-
+! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
+! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
+|-
+! colspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
+! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
+|-
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fatigue
+! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
+! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinary symptoms
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood Pressure
+! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin lesions
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Edema
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |ABG
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transtubular potassium gradient
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urine Potassium:Creatinine
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasonography
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
+|-
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Polyuria
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Oliguria
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nocturia
+|-
+! rowspan="7" style="background: #DCDCDC; text-align: center;" |[[Renal]] and [[adrenal disorders]]
+! style="background: #DCDCDC; text-align: center;" |[[Loop diuretics|Loop diuretic use]]<ref name="pmid8199766">{{cite journal |vauthors=Bourke E, Delaney V |title=Prevention of hypokalemia caused by diuretics |journal=Heart Dis Stroke |volume=3 |issue=2 |pages=63–7 |date=1994 |pmid=8199766 |doi= |url=}}</ref>
+! +/−
+!−
+! +
+!−
+! +/−
+!↓
+!−
+! +
+![[Metabolic alkalosis]]
+!↑[[Potassium|K<sup>+</sup>]]
+! rowspan="7" |> 7
+! rowspan="7" |>20mEq/g
+!↑'''[[Sodium|Na<sup>+</sup>]]'''
+!−
+!−
+!History of medication use
+!−
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Primary hyperaldosteronism]]<ref name="pmid28101185">{{cite journal| author=Wu C, Xin J, Xin M, Zou H, Jing L, Zhu C et al.| title=Hypokalemic myopathy in primary aldosteronism: A case report. | journal=Exp Ther Med | year= 2016 | volume= 12 | issue= 6 | pages= 4064-4066 | pmid=28101185 | doi=10.3892/etm.2016.3864 | pmc=5228118 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28101185  }}</ref>
+! +
+!−
+! +
+!−
+! +
+!↑
+![[Facial flushing]]
+!−
+![[Metabolic alkalosis]]
+!↑[[Potassium|K<sup>+</sup>]], ↓'''[[Sodium|Na<sup>+</sup>]]'''
+!↓'''[[Plasma renin activity|PRA]]''', ↑'''[[Aldosterone|PAC]], ↓[[Sodium|Na<sup>+</sup>]]'''
+!Unilateral [[adrenal hyperplasia]]
+!Hypodense unilateral [[Adrenal Mass|adrenal macroadenoma]] (>1 cm)
+!'''[[Aldosterone|PAC]]:[[Plasma renin activity|PRA]] ratio'''
+![[Mood disturbances|Mood disturbance]], [[Paresthesias|paresthesia]], [[muscle cramps]]
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Cushing syndrome]]<ref name="pmid12381548">{{cite journal |vauthors=Torpy DJ, Mullen N, Ilias I, Nieman LK |title=Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases |journal=Ann. N. Y. Acad. Sci. |volume=970 |issue= |pages=134–44 |date=September 2002 |pmid=12381548 |doi= |url=}}</ref>
+! +
+! +/−
+! +/−
+!−
+!−
+!↑
+![[Plethora|Facial plethora]], [[Striae|purple striae]]
+! +
+![[Metabolic alkalosis]]
+![[Glucosuria]]
+!↑[[Blood sugar|BS]]
+!Unilateral [[adrenal hyperplasia]]
+!−
+!'''Urinary free [[cortisol]] (24−hour)'''
+!Dorsicocervical [[fat pad]], [[obesity]], [[hirsutism]]
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Hemodialysis]]<ref name="pmid23946760">{{cite journal| author=Choi HY, Ha SK| title=Potassium balances in maintenance hemodialysis. | journal=Electrolyte Blood Press | year= 2013 | volume= 11 | issue= 1 | pages= 9-16 | pmid=23946760 | doi=10.5049/EBP.2013.11.1.9 | pmc=3741441 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23946760  }}</ref>
+! +/−
+! +/−
+! +/−
+!−
+!−
+!Normal
+![[Pustular rash|Pustular lesions]]
+!−
+![[Metabolic alkalosis]]
+!Normal
+!↓'''[[Sodium|Na<sup>+</sup>]]'''
+!−
+!−
+!History
+![[Carpal tunnel syndrome]]
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Bartter syndrome]]<ref name="pmid12920401">{{cite journal |vauthors=Hebert SC |title=Bartter syndrome |journal=Curr. Opin. Nephrol. Hypertens. |volume=12 |issue=5 |pages=527–32 |date=September 2003 |pmid=12920401 |doi=10.1097/01.mnh.0000088732.87142.43 |url=}}</ref>
+! +
+!−
+! +
+!−
+! +/−
+!Normal or ↓
+!−
+!−
+![[Metabolic alkalosis]]
+!↑[[Potassium|K<sup>+</sup>]], ↑[[Ca|Ca<sup>+2</sup>]], ↑[[Chloride|Cl<sup>-</sup>]]
+!−
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Mental retardation]], [[sensorineural hearing loss]]
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Gitelman syndrome]]<ref name="pmid18667063">{{cite journal| author=Knoers NV, Levtchenko EN| title=Gitelman syndrome. | journal=Orphanet J Rare Dis | year= 2008 | volume= 3 | issue=  | pages= 22 | pmid=18667063 | doi=10.1186/1750-1172-3-22 | pmc=2518128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18667063  }}</ref>
+! +
+!−
+! +
+!−
+! +
+!Normal
+!−
+!−
+![[Metabolic alkalosis]]
+!↑[[Potassium|K<sup>+</sup>]], ↓[[Ca|Ca<sup>+2</sup>]], ↑[[Chloride|Cl<sup>-</sup>]]
+!−
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Growth retardation]], [[tetany]], [[muscle cramp]]
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Liddle syndrome]]<ref name="pmid29534496">{{cite journal |vauthors=Tetti M, Monticone S, Burrello J, Matarazzo P, Veglio F, Pasini B, Jeunemaitre X, Mulatero P |title=Liddle Syndrome: Review of the Literature and Description of a New Case |journal=Int J Mol Sci |volume=19 |issue=3 |pages= |date=March 2018 |pmid=29534496 |pmc=5877673 |doi=10.3390/ijms19030812 |url=}}</ref>
+!−
+!−
+! +/−
+!−
+!−
+!↑
+!−
+! +/−
+![[Metabolic alkalosis]]
+!↑[[Potassium|K<sup>+</sup>]], ↓'''[[Sodium|Na<sup>+</sup>]]'''
+!↓'''[[Plasma renin activity|PRA]]''', ↓'''[[Aldosterone|PAC]]'''
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Pseudohyperaldosteronism]]
+|-
+! rowspan="5" style="background: #DCDCDC; text-align: center;" |[[Gastrointestinal disorders]]
+! style="background: #DCDCDC; text-align: center;" |[[Gastrointestinal bleeding|GI bleeding]]<ref name="pmid22901631">{{cite journal| author=Asmar A, Mohandas R, Wingo CS| title=A physiologic-based approach to the treatment of a patient with hypokalemia. | journal=Am J Kidney Dis | year= 2012 | volume= 60 | issue= 3 | pages= 492-7 | pmid=22901631 | doi=10.1053/j.ajkd.2012.01.031 | pmc=4776048 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22901631  }}</ref>
+! +
+!−
+!−
+! +
+!−
+!↓
+!−
+!−
+!Normal
+!Normal
+! rowspan="16" |< 3
+! rowspan="16" |< 20 mEq/g
+![[Anemia]]
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Orthostatic hypotension]], [[bradycardia]]
+|-
+! style="background: #DCDCDC; text-align: center;" |[[Vomiting]]<ref name="pmid22169581">{{cite journal |vauthors=Cheungpasitporn W, Suksaranjit P, Chanprasert S |title=Pathophysiology of vomiting-induced hypokalemia and diagnostic approach |journal=Am J Emerg Med |volume=30 |issue=2 |pages=384 |date=February 2012 |pmid=22169581 |doi=10.1016/j.ajem.2011.10.005 |url=}}</ref>
+! +
+!−
+!−
+! +
+!−
+!↓
+!−
+!−
+![[Metabolic alkalosis]]
+![[Chloride|Cl<sup>-</sup>]] <20 mEq/L
+!−
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+!Dry [[mucous membranes]], [[lethargy]]
+|-
+! style="background: #DCDCDC; text-align: center;" |Severe [[diarrhea]]<ref name="pmid28580600">{{cite journal |vauthors=Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M |title=Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature |journal=Neurogastroenterol. Motil. |volume=29 |issue=11 |pages= |date=November 2017 |pmid=28580600 |doi=10.1111/nmo.13120 |url=}}</ref>
+! +
+!−
+!−
+! +
+!−
+!↓
+!−
+!−
+![[Metabolic alkalosis]]
+![[Potassium|K<sup>+</sup>]]<20 mEq/L
+!−
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+!Dry [[mucous membranes]], [[lethargy]]
 |-
-| rowspan="5" |Central
+! style="background: #DCDCDC; text-align: center;" |[[Villous adenoma]]<ref name="pmid24199207">{{cite journal| author=Sanchez Garcia S, Villarejo Campos P, Manzanares Campillo Mdel C, Gil Rendo A, Muñoz Atienza V, García Santos EP et al.| title=Hypersecretory villous adenoma as the primary cause of an intestinal intussusception and McKittrick-Wheelock syndrome. | journal=Can J Gastroenterol | year= 2013 | volume= 27 | issue= 11 | pages= 621-2 | pmid=24199207 | doi= | pmc=3816940 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24199207  }}</ref>
-| rowspan="3" |Acquired
+! +
-|[[Histiocytosis]]
+!−
-|
+!−
-* Bone lysis and [[Bone fracture|fracture]]
+! +
-* Purulent [[otitis media]]
+!−
-* [[Diabetes insipidus]] and delayed puberty
+!↓
-* [[Maxillary]], [[mandibular]], and [[gingival]] disease
+!−
-* [[Rash]] and [[Erythematous|maculoerythematous]] skin lesions
+!−
-* Scaly, [[erythematous]] scalp patches
+!Normal
-* [[Lung]] involvement
+![[Potassium|K<sup>+</sup>]] and [[Chloride|Cl<sup>-</sup>]] <20 mEq/L
-* [[GI bleeding]]
+![[Anemia]]
-* [[Lymphadenopathy|Lymph node enlargement]]<ref name="pmid1340034">{{cite journal| author=Ghosh KN, Bhattacharya A| title=Gonotrophic nature of Phlebotomus argentipes (Diptera: Psychodidae) in the laboratory. | journal=Rev Inst Med Trop Sao Paulo | year= 1992 | volume= 34 | issue= 2 | pages= 181-2 | pmid=1340034 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1340034  }} </ref>
+!−
-|
+!−
-* CD1a and CD45 +
+![[Colonoscopy]]
-* Interleukin-17 (ILITA)
+![[Hematochezia]]
-[[Image:Langerhans Skull X ray.jpg|center|300px|thumb|Skull x-ray of a patient with Langerhan's histiocytosis showing lytic lesions - Case courtesy of Dr Hani Salam, Radiopaedia.org, rID: 9459]]
 |-
-|[[Craniopharyngioma]]
+! style="background: #DCDCDC; text-align: center;" |[[VIPoma]]<ref name="pmid3035922">{{cite journal |vauthors=Krejs GJ |title=VIPoma syndrome |journal=Am. J. Med. |volume=82 |issue=5B |pages=37–48 |date=May 1987 |pmid=3035922 |doi= |url=}}</ref>
-|
+! +
-* [[Headache]]
+! +/−
-* [[Endocrine disorders|Endocrine dysfunction]]
+!−
-** [[Diabetes insipidus]]
+! +
-** [[Hypothyroidism]]
+!−
-** [[Adrenal failure]]
+!↓
-** [[Diabetes insipidus]] (e.g., excessive fluid intake and urination)
+![[Facial flushing]], [[skin rash]]
-** Growth failure and [[delayed puberty]]
+! +
-|
+!Normal
-* [[Suprasellar]] calcified cyst on [[MRI]]
+![[Potassium|K<sup>+</sup>]]<20 mEq/L
-[[Image:Craniopharyngioma-papillary-1.jpg|center|300px|thumb|Brain MRI showing suprasellar mass consistent with the diagnosis of craniopharyngioma - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 16812]]
+!'''[[Osmolarity|Stool osmolar gap]] '''<50 mOsm/kg
+!'''[[Endoscopic ultrasound]] for''' [[VIPoma|VIPomas]] of 2−3 mm
+![[Pancreatic]] [[VIPoma|VIPomas]] >3 cm
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Weight loss]]
 |-
-|[[Sarcoidosis]]
+! rowspan="5" style="background: #DCDCDC; text-align: center;" |[[Neuropsychiatric|Neuropsychiatric disorders]]
-|
+! style="background: #DCDCDC; text-align: center;" |[[Polydipsia|Primary polydipsia]]<ref name="pmid25688318">{{cite journal| author=Gill M, McCauley M| title=Psychogenic polydipsia: the result, or cause of, deteriorating psychotic symptoms? A case report of the consequences of water intoxication. | journal=Case Rep Psychiatry | year= 2015 | volume= 2015 | issue=  | pages= 846459 | pmid=25688318 | doi=10.1155/2015/846459 | pmc=4320790 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25688318  }}</ref>
-* Systemic complaints
+!−
-** [[Fever]]
+!−
-** [[Anorexia]]
+! +
-** [[Arthralgias]]
+!−
-* Pulmonary complaints
+! +
-** [[Dyspnea on exertion]]
+!Normal
-** [[Cough]]
+!−
-** Chest pain,
+! +/−
-** [[Hemoptysis]] (rare)
+!Normal
-* [[Diabetes mellitus]]
+!↓[[Osmolarity|Urine osmolarity]]
-|
+!↓'''[[Sodium|Na<sup>+</sup>]]'''
-* [[Hypercalcemia]]
+!−
-* [[Hypercalciuria]] ([[Granulomas|noncaseating granulomas]])
+!−
-* Elevated [[alkaline phosphatase]]
+!'''Water restriction test'''
-* [[Serum amyloid A]] (SAA)
+![[Psychosis]]
-* [[Angiotensin-converting enzyme|ACE]] levels may be elevated
-[[Image:Neurosarcoidosis.jpg|center|300px|thumb|Contrast-enhanced patches in a patient previously diagnosed with lung sarcoidosis - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 10930]]
 |-
-| rowspan="2" |Congenital
+! style="background: #DCDCDC; text-align: center;" |[[Central diabetes insipidus]]<ref name="pmid24707338">{{cite journal| author=Nguyen FN, Kar JK, Verduzco-Gutierrez M, Zakaria A| title=A case of hypokalemic paralysis in a patient with neurogenic diabetes insipidus. | journal=Neurohospitalist | year= 2014 | volume= 4 | issue= 2 | pages= 90-3 | pmid=24707338 | doi=10.1177/1941874413495702 | pmc=3975788 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24707338  }}</ref>
-|[[Hydrocephalus]]
+! +
-|
+!−
-* Cognitive deterioration
+! +
-* [[Headaches]]
+!−
-* [[Neck pain]]
+! +
-* [[Blurred vision]]
+!Normal or ↓
-* [[Unsteady gait]]
+!−
-* [[Incontinence]] such as [[polyuria]]
+!−
-|Dilated [[ventricles]] on [[Computed tomography|CT]] and [[Magnetic resonance imaging|MRI]]
+!Normal
-[[Image:Obstructive-hydrocephalus.jpg|center|300px|thumb|Obstructive hydrocephalus showing dilated lateral ventricles - Case courtesy of Dr Paul Simkin, Radiopaedia.org, rID: 30453]]
+!↓[[Osmolarity|Urine osmolarity]]
+!↑'''[[Sodium|Na<sup>+</sup>]]'''
+!−
+!−
+!'''Water restriction test'''
+![[Encephalopathy|Ischemic encephalopathy]]
 |-
-|[[Wolfram syndrome|Wolfram Syndrome]] (DIDMOAD)
+! style="background: #DCDCDC; text-align: center;" |[[Bulimia nervosa]]<ref name="pmid15213788">{{cite journal| author=Rushing JM, Jones LE, Carney CP| title=Bulimia Nervosa: A Primary Care Review. | journal=Prim Care Companion J Clin Psychiatry | year= 2003 | volume= 5 | issue= 5 | pages= 217-224 | pmid=15213788 | doi= | pmc=419300 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15213788  }}</ref>
-|
+!−
-* [[Diabetes insipidus|Diabetes Insipidus]]
+!−
-* [[Diabetes mellitus|Diabetes Mellitus]]
+!−
-* [[Optic atrophy|Optic Atrophy]]
+! +/−
-* [[Deafness]]
+!−
-|
+!Normal or ↓
-* Negative [[islet cell]] antibodies
+![[Asteatotic Dermatitis|Asteatotic '''skin''']] '''[[Carotenodermia|C]]'''[[Carotenodermia|arotenodermia]]
-* [[Optic atrophy]] on [[electroretinogram]]
+!−
-* [[Deafness]] on [[audiogram]]
+!Normal
-* [[Atrophy]] of brain stem on [[Magnetic resonance imaging|MRI]]
+!↑[[Potassium|K<sup>+</sup>]], ↓[[Chloride|Cl<sup>-</sup>]]
+!−
+!−
+!−
+![[Psychological analysis|Psychological interview]]
+! [[Parotid gland]] enlargement, [[lanugo]]−like hair
 |-
-| rowspan="5" |[[Nephrogenic diabetes insipidus|Nephrogenic]]
+! style="background: #DCDCDC; text-align: center;" |[[Anorexia nervosa]]<ref name="pmid21670105">{{cite journal| author=Liang CC, Yeh HC| title=Hypokalemic nephropathy in anorexia nervosa. | journal=CMAJ | year= 2011 | volume= 183 | issue= 11 | pages= E761 | pmid=21670105 | doi=10.1503/cmaj.101790 | pmc=3153553 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21670105  }}</ref>
-| rowspan="5" |[[Acquired disorder|Acquired]]
+! +
-|Drug-induced ([[demeclocycline]], [[lithium]])
+!−
-|
+!−
-* [[Polyuria]]
+! +/−
-* [[Polydipsia]]
+!−
-* [[Nocturia]]
+!↓
-|
+![[Xerosis]], [[Telogen effluvium|hair effluvium]]
-* [[Urine osmolality]] <100 mmol/
+!−
-* [[Arginine vasopressin]] level >4.6 pmol/
+!Normal
-* Little or no response to administration of  exogenous [[arginine vasopressin]]
+!↑[[Potassium|K<sup>+</sup>]], ↓[[Chloride|Cl<sup>-</sup>]]
+!−
+!−
+!−
+![[Psychological analysis|Psychological interview]]
+![[Orthostatic hypotension]], [[bradycardia]]
 |-
-|[[Hypercalcemia]]
+! style="background: #DCDCDC; text-align: center;" |[[Hypokalemic periodic paralysis]]<ref name="urlHypokalemic periodic paralysis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/6729/hypokalemic-periodic-paralysis |title=Hypokalemic periodic paralysis &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
-|
+! +
-* [[Polyuria]]
+!−
-* [[Polydipsia]]
+!−
-* [[Gastrointestinal]] disturbances
+!−
-* [[Bone fracture|Pathological fractures]]
+! +/−
-* [[Confusion]]
+!Normal or ↓
-* [[Palpitations]] and [[cardiac arrhythmias]]
+!−
-|
+! +/−
-* Ca levels greater than 11 meq/L
+![[Metabolic alkalosis]]
+![[Potassium|K<sup>+</sup>]]<20 mEq/L
+![[Thyrotoxicosis]], ↓[[Magnesium|Mg<sup>+</sup>]], ↓PO<sub>4</sub><sup>-3</sup>
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Paralysis|Paralytic episodes]], [[arrhythmias]]
 |-
-|[[Hypokalemia]]
+! rowspan="6" style="background: #DCDCDC; text-align: center;" |[[Systemic diseases]]
-|
+! style="background: #DCDCDC; text-align: center;" |[[Hypothermia]]<ref name="pmid9795553">{{cite journal |vauthors=Zydlewski AW, Hasbargen JA |title=Hypothermia-induced hypokalemia |journal=Mil Med |volume=163 |issue=10 |pages=719–21 |date=October 1998 |pmid=9795553 |doi= |url=}}</ref>
-* [[Polyuria]]
+!−
-* [[Hyporeflexia]]
+!−
-* [[Palpitations]] and [[cardiac arrhythmias]]
+!−
-|
+! +/−
-* K levels less than 3meq/L on CBC
+!−
+!Normal
+![[Frostbite]]
+!−
+!Normal
+!Normal
+!−
+!−
+!−
+!Clinical findings
+![[Loss of consciousness|Impaired mental state]]
 |-
-|[[Multiple myeloma]]
+! style="background: #DCDCDC; text-align: center;" |[[Alcoholism]]<ref name="pmid12189007">{{cite journal |vauthors=Elisaf M, Liberopoulos E, Bairaktari E, Siamopoulos K |title=Hypokalaemia in alcoholic patients |journal=Drug Alcohol Rev |volume=21 |issue=1 |pages=73–6 |date=March 2002 |pmid=12189007 |doi=10.1080/09595230220119282 |url=}}</ref>
-|
+! +
-* Pathologic [[bone fractures]]
+! +/−
-* [[Bleeding]]
+! +
-* [[Hypercalcemia]] leading to [[polyuria]]
+!−
-* [[Infection]]
+! +
-* [[Hyperviscosity]]
+!Normal or ↓
-* [[Anemia]]
+![[Icterus]], [[caput medusae]]
-|
+! +
-* [[IgG]] or [[IgA]] spike on [[serum protein electrophoresis]]
+![[Metabolic alkalosis]]
-* [[Monoclonal antibody|Monoclonal M spike]]
+![[Ketonuria]]
-* Disordered [[plasma cell]] proliferation on [[bone marrow biopsy]]
+![[Anemia]]
-[[Image:Multiple-myeloma-skeletal-survey.jpg|center|300px|thumb|Skeletal survey in a patient with multiple myeloma showing multiple lytic lesions - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 7682]]
+!−
+!−
+!Clinical findings
+![[Digital clubbing]], [[gynecomastia]]
 |-
-|[[Sickle-cell disease|Sickle cell disease]]
+! style="background: #DCDCDC; text-align: center;" |[[Diabetic ketoacidosis]]<ref name="pmid25430801">{{cite journal| author=Davis SM, Maddux AB, Alonso GT, Okada CR, Mourani PM, Maahs DM| title=Profound hypokalemia associated with severe diabetic ketoacidosis. | journal=Pediatr Diabetes | year= 2016 | volume= 17 | issue= 1 | pages= 61-5 | pmid=25430801 | doi=10.1111/pedi.12246 | pmc=4896141 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25430801  }}</ref>
-|
+! +
-* [[Chronic pain]]
+! +/−
-* [[Anemia]]
+! +
-* [[Aplastic crisis]]
+!−
-* Splenic sequestration
+! +
-* [[Infection]]
+!↓
-* [[Isosthenuria]] presenting with [[polyuria]]
+![[Xerosis]]
-|
+!−
-* [[Hemoglobin]] level is 5-9 g/dL
+![[Metabolic acidosis]]
-* [[Hematocrit]] is decreased to 17-29%
+![[Ketonuria]]
-* [[Peripheral blood smear|Peripheral blood smears]] demonstrate [[Target cell|target cells]], elongated cells, and characteristic sickle erythrocytes
+!↑Serum [[ketone]], ↑ [[blood glucose]]
-* MRI can demonstrate [[avascular necrosis]] of the [[femoral]] and [[humeral]] heads
+!−
-[[Image:Sickle cells.jpg|center|300px|thumb|Blood film showing the sickle cells - By Dr Graham Beards - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=18421017]]
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+!Dry [[mucous membranes]], [[shock]]
 |-
-| colspan="2" |Primary polydipsia
+! style="background: #DCDCDC; text-align: center;" |[[Hypomagnesemia]]<ref name="pmid17804670">{{cite journal |vauthors=Huang CL, Kuo E |title=Mechanism of hypokalemia in magnesium deficiency |journal=J. Am. Soc. Nephrol. |volume=18 |issue=10 |pages=2649–52 |date=October 2007 |pmid=17804670 |doi=10.1681/ASN.2007070792 |url=}}</ref>
-|[[Psychogenic]]
+! +
-|
+!−
-* [[Polyuria]]
+!−
-* [[Polydipsia]]
+! +/−
-* [[Nocturia]]
+!−
-|
+!Normal
-* Dry mucus membrane
+!−
-* History of [[psychiatric disorders]]
+! +/−
+![[Metabolic alkalosis]]
+!−
+!↓[[Calcium|Ca<sup>+2</sup>]]
+!−
+!−
+![[Bartter syndrome laboratory findings|Laboratory findings]]
+![[Trousseau's sign|Trousseau]] and [[Chvostek's Sign|Chvostek signs]]
 |-
-| colspan="3" |Gestational diabetes insipidus
+! style="background: #DCDCDC; text-align: center;" |[[Burns]]<ref name="pmid27183443">{{cite journal| author=Nielson CB, Duethman NC, Howard JM, Moncure M, Wood JG| title=Burns: Pathophysiology of Systemic Complications and Current Management. | journal=J Burn Care Res | year= 2017 | volume= 38 | issue= 1 | pages= e469-e481 | pmid=27183443 | doi=10.1097/BCR.0000000000000355 | pmc=5214064 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27183443  }}</ref>
-|
+! +/−
-* [[Polyuria]]
+!−
-* [[Polydipsia]]
+!−
-* [[Nocturia]]
+! +
-* [[Pregnancy]]
+!−
-|
+!↓
-* Dry mucus membranes
+![[Vesicle]] and bullae, [[erythema]]
-* [[Pregnancy]]
+! +
+!Normal
+!−
+![[Acute phase reactant]]
+!−
+!−
+!Clinical findings
+![[Dehydration]]
 |-
-| colspan="3" |[[Diabetes mellitus]]
+! style="background: #DCDCDC; text-align: center;" |[[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>
-|
+! +/−
-* [[Polyuria]]
+! +/−
-* [[Polydipsia]]
+!−
-* [[Nocturia]]
+! +/−
-* [[Weight gain (patient information)|Weight gain]]
+!−
-|
+!↓
-* Elevated blood sugar levels >126
+![[Aquagenic wrinkling of the palms|Early aquagenic '''skin''' wrinkling]]
-* Elevated [[HbA1c]] > 6.5
+! +/−
+!Normal
+!−
+!−
+! -
+![[Pulmonary]] infiltration
+!'''[[Sweat chloride test]]'''
+![[Pancreatic insufficiency]]
 |}