Sandbox: wdx causes: Difference between revisions
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! 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;" + | - | ||
| 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;" + | | | align="center" style="background:#F5F5F5;" + | - | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
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| 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;" + |Nl | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + |↑ | | align="center" style="background:#F5F5F5;" + |↑ | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Nl to ↑ | ||
| align="center" style="background:#F5F5F5;" + | | | 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="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* [[Constipation]] | |||
* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]] | |||
* [[Failure to thrive]] | |||
* [[Sensorineural hearing loss|Sensorineural deafness]] | |||
* [[Focal segmental glomerulosclerosis]] | |||
* [[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> | ! 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> | ||
| 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;" + | | | 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;" + | + | ||
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| 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;" + |Nl | ||
| 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;" + | | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Nl | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + | | ||
| align="left" style="background:#F5F5F5;" + | | | align="left" style="background:#F5F5F5;" + | | ||
* Less severe | |||
* [[Constipation]] | |||
* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]] | |||
* [[Hypocalciuria]] | * [[Hypocalciuria]] | ||
|- | |- | ||
Revision as of 14:47, 20 May 2018
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 |
| |
| Milk−alkali syndrome[2] | − | + | − | + | − | + | − | + | ↓ | + | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | ↓ | ↑ | ↑ | ↑ | Nl | Clinical + 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 | |
| Penicillin[5] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | Nl | Nl | Nl | History | |||
| Licorice[6][7] | + | − | − | + | − | − | − | + | Nl to ↑ | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | Clinical | |||
| 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 | ||
| 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 | ||
| Nasogastric tube suction[12] | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical | |||
| 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 + lab data |
| ||
| 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 data | Chronic respiratory acidosis | |
| Hypomagnesemia[20] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab data | |||
| Hypokalemia[21] | + | − | − | − | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab data | |||
| Bartter's syndrome[22] | + | - | - | + | - | - | - | - | Nl | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | ↓ | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | ||||
| Gitelman’s syndrome[23] | + | - | - | + | - | - | - | - | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl |
| |||
| Renal artery stenosis | ↑ | ↑ | Nl | |||||||||||||||||||||||
| Liddle syndrome | + | ↑ | ||||||||||||||||||||||||
| Renal tumors | ||||||||||||||||||||||||||
| Endocrine | Cushing's syndrome | ↑ | ↓ | Nl | ||||||||||||||||||||||
| Hyperaldosteronism | Primary | ↑ | ↓ | ↓ | Nl | |||||||||||||||||||||
| Secondary | ↓ | |||||||||||||||||||||||||
| Adrenal enzyme defects | 11β−Hydroxylase deficiency | ↓ | ↓ | |||||||||||||||||||||||
| 17α−Hydroxylase deficiency | ↓ | ↓ | ||||||||||||||||||||||||
| Hypercalcemia/hypoparathyroidism | + | ↑ | ||||||||||||||||||||||||
| Systemic | Cystic fibrosis | + | ||||||||||||||||||||||||
| 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 | |
- ↑ 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.