|
|
| (2 intermediate revisions by 2 users not shown) |
| Line 1: |
Line 1: |
| {{DiseaseDisorder infobox |
| | __NOTOC__ |
| Name = Hyperchloremia |
| | '''For patient information, click [[Hyperchloremia (patient information)|here]]''' |
| ICD10 = {{ICD10|E|87|8|e|70}} |
| | {{Hyperchloremia}} |
| ICD9 = {{ICD9|276.9}} |
| |
| }}
| |
| | |
| {{SI}}
| |
| | |
| {{CMG}} | | {{CMG}} |
|
| |
|
| {{EH}}
| | ==[[Hyperchloremia overview|Overview]]== |
|
| |
|
| ==Overview== | | ==[[Hyperchloremia classification|Classification]]== |
| '''Hyperchloremia''' is an [[electrolyte disturbance]] in which there is an abnormally elevated level of the [[chloride]] ion in the [[blood]]. The normal serum range for chloride is 97 to 107 mEq/L. Hyperchloremia is defined as a chloride concentration exceeding this level.
| |
|
| |
|
| ==Symptoms== | | ==[[Hyperchloremia pathophysiology|Pathophysiology]]== |
| Often hyperchloremia does not produce any symptoms. However, hyperchloremia is sometimes associated with excess fluid loss such as vomiting and diarrhea. If the sufferer is a diabetic, hyperchloremia may lead to poor control of blood sugar levels, causing them to become elevated. Hyperchloremia can be symptomatic with signs of Kussmaul's breathing, weakness, and intense thirst.
| |
|
| |
| ==Causes==
| |
| Elevations in chloride may be associated with [[diarrhea]], certain [[kidney]] diseases, and overactivity of the [[parathyroid gland]]s. Hyperchloremia is often [[comorbidity|comorbid]] with [[diabetes]] or [[hyponatremia]]. Certain drugs, especially [[diuretic]]s such as carbonic anhydrase inhibitors, [[hormone|hormonal]] treatments, and [[polypharmacy]], may contribute to this disorder.
| |
|
| |
|
| === Complete Differential Diagnosis of the Causes of Hyperchloremia=== | | ==[[Hyperchloremia causes|Causes]]== |
| (In alphabetical order)
| |
| * Artifact (low [[anion gap]])
| |
| * [[Dehydration]]
| |
| * [[Drugs]]
| |
| * [[Hypernatremia]]
| |
| * [[Hyperparathyroidism]]
| |
| * Ileul loops
| |
| * Loss of pancreatic secretion
| |
| * [[Metabolic acidosis]]
| |
| * [[Nephrotic syndrome]]
| |
| * Prolonged [[diarrhea]]
| |
| * [[Renal failure]]
| |
| * [[Renal tubular acidosis]]
| |
| * [[Respiratory alkalosis]]
| |
| * [[Ureter]]al [[colon]]ic [[anastomosis]]
| |
|
| |
|
| ===Complete Differential Diagnosis of the Causes of Hyperchloremia=== | | ==[[Hyperchloremia differential diagnosis|Differentiating Hyperchloremia from other Diseases]]== |
| (By organ system)
| |
| {|style="width:80%; height:100px" border="1"
| |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Chemical / poisoning'''
| |
| |bgcolor="Beige"| [[Drugs]]
| |
| |- | |
| |-bgcolor="LightSteelBlue"
| |
| | '''Dermatologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Drug Side Effect'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ear Nose Throat'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Endocrine'''
| |
| |bgcolor="Beige"| [[Hyperparathyroidism]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Environmental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Gastroenterologic'''
| |
| |bgcolor="Beige"| Ileul loops, Loss of pancreatic secretion, Prolonged [[diarrhea]], [[Ureter]]al [[colon]]ic [[anastomosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Genetic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Hematologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Iatrogenic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Infectious Disease'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Musculoskeletal / Ortho'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Neurologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Nutritional / Metabolic'''
| |
| |bgcolor="Beige"| [[Dehydration]], [[Hypernatremia]], [[Metabolic acidosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Obstetric/Gynecologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Oncologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Opthalmologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Overdose / Toxicity'''
| |
| |bgcolor="Beige"| [[Drugs]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Psychiatric'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Pulmonary'''
| |
| |bgcolor="Beige"| [[Respiratory alkalosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Renal / Electrolyte'''
| |
| |bgcolor="Beige"| Artifact (low [[anion gap]]), [[Dehydration]], [[Hypernatremia]], [[Metabolic acidosis]], [[Nephrotic syndrome]], [[Renal failure]], [[Renal tubular acidosis]], [[Respiratory alkalosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Rheum / Immune / Allergy'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Sexual'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Trauma'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Urologic'''
| |
| |bgcolor="Beige"| [[Nephrotic syndrome]], [[Renal failure]], [[Renal tubular acidosis]], [[Ureter]]al [[colon]]ic [[anastomosis]]
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Miscellaneous'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |}
| |
|
| |
|
| | ==[[Hyperchloremia epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| ==Treatment== | | ==[[Hyperchloremia risk factors|Risk Factors]]== |
| As with most types of electrolyte imbalance, the treatment of high blood chloride levels is based on correcting the underlying cause.
| |
|
| |
|
| *If the patient is dehydrated, therapy consists of establishing and maintaining adequate hydration.
| | ==[[Hyperchloremia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
|
| |
|
| *If the condition is caused or exacerbated by medications or treatments, these may be altered or discontinued, if deemed prudent.
| | ==Diagnosis== |
|
| |
|
| *If there is underlying kidney disease (which is likely if there are other electrolyte disturbances), then the patient will be referred to a [[nephrologist]] for further care.
| | [[Hyperchloremia history and symptoms|History and Symptoms]] | [[Hyperchloremia physical examination|Physical Examination]] | [[Hyperchloremia laboratory findings|Laboratory Findings]] | [[Hyperchloremia other diagnostic studies|Other Diagnostic Studies]] |
|
| |
|
| *If there is an underlying dysfunction of the endocrine or hormone system, the patient will likely be referred to an [[endocrinologist]] for further assessment.
| | ==Treatment== |
|
| |
|
| ==References== | | [[Hyperchloremia medical therapy|Medical Therapy]] | [[Hyperchloremia primary prevention|Primary Prevention]] |
| | ==Case Studies== |
| | [[Hyperchloremia case study one|Case #1]] |
|
| |
|
| ==External links== | | ==Related Chapters== |
| * [http://www.fpnotebook.com/REN11.htm FP Notebook] | | *[[Renal tubular acidosis|Renal Tubular Acidosis]] |
|
| |
|
| {{Endocrine, nutritional and metabolic pathology}} | | {{Endocrine, nutritional and metabolic pathology}} |