Metabolic alkalosis differential diagnosis: Difference between revisions
Created page with "__NOTOC__ {{Metabolic alkalosis}} {{CMG}}; {{AE}} ==Overview== [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2..." |
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[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3]. | [Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3]. | ||
== | == Metabolic Alkalosis == | ||
*[ | '''''Differential diagnosis of metabolic alkalosis is as follow''''': | ||
*[ | {| | ||
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | |||
! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | |||
! colspan="4" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Mechanism | |||
! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical | |||
! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical | |||
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis | |||
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | |||
|- | |||
! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms | |||
! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs | |||
! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab data | |||
|- | |||
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |ABG | |||
! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Chemistry | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Enzyme | |||
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal function | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup> | |||
|- | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Exogenous HCO<sub><big>3</big></sub><sup>−</sup> loads | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Acute alkali administration<ref name="MáttarWeil1974">{{cite journal|last1=Máttar|first1=João A.|last2=Weil|first2=Max Harry|last3=Shubin|first3=Herbert|last4=Stein|first4=Leon|title=Cardiac arrest in the critically III|journal=The American Journal of Medicine|volume=56|issue=2|year=1974|pages=162–168|issn=00029343|doi=10.1016/0002-9343(74)90593-2}}</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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Clinical | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Post treatment of [[lactic acidosis]] or [[ketoacidosis]] | |||
* 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> | |||
| 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;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Clinical + exclusion of other causes of [[hypercalcemia]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Ingestion of large amounts of calcium and absorbable alkali | |||
* [[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> | |||
| 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;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |History of administration of large quantities of [[blood]] products that contain [[sodium citrate]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Associated with [[Renal insufficiency|renal impairment]] | |||
|- | |||
! 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="left" style="background:#DCDCDC;" + | | |||
* Bumetanide | |||
* Chlorothiazide | |||
* Metolazone | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |History | |||
| align="left" style="background:#F5F5F5;" + | | |||
* [[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> | |||
| 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;" + |Nl | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |History | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Licorice<ref name="MeltemFigen2009">{{cite journal|last1=Meltem|first1=Akkas Camkurt|last2=Figen|first2=Coskun|last3=Nalan|first3=Metin Aksu|last4=Mahir|first4=Kunt|last5=Sebnem|first5=Bozkurt|last6=Mehlika|first6=Isildak|last7=Kasim|first7=Kilic Ahmet|last8=Miyase|first8=Bayraktar|title=A hypokalemic muscular weakness after licorice ingestion: a case report|journal=Cases Journal|volume=2|issue=1|year=2009|pages=8053|issn=1757-1626|doi=10.4076/1757-1626-2-8053}}</ref><ref name="LinYang2003">{{cite journal|last1=Lin|first1=Shih-Hua|last2=Yang|first2=Sung-Sen|last3=Chau|first3=Tom|last4=Halperin|first4=Mitchell L.|title=An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion|journal=The American Journal of the Medical Sciences|volume=325|issue=3|year=2003|pages=153–156|issn=00029629|doi=10.1097/00000441-200303000-00008}}</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;" + |Nl to ↑ | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| 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;" + |Clinical | |||
| align="left" style="background:#F5F5F5;" + | | |||
* [[Muscle weakness]] | |||
* | * [[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> | ||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |High level of suspicion | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Large−volume, [[Diarrhea|watery diarrhea]] | |||
* Cramping [[abdominal pain]] | |||
* [[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="left" style="background:#DCDCDC;" + | | |||
* Aluminum hydroxide | |||
* Sodium polystyrene sulfonate | |||
| 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;" + |Nl | |||
| 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;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Clinical | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | |||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | |||
|- | |||
! 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> | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Clinical | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction<ref name="GilbertsonRogers2011">{{cite journal|last1=Gilbertson|first1=Heather Ruth|last2=Rogers|first2=Elizabeth Jessie|last3=Ukoumunne|first3=Obioha Chukwunyere|title=Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement|journal=Journal of Parenteral and Enteral Nutrition|volume=35|issue=4|year=2011|pages=540–544|issn=0148-6071|doi=10.1177/0148607110383285}}</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;" + |Nl | |||
| 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;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Clinical | |||
| align="left" style="background:#F5F5F5;" + | | |||
* [[Gastroesophageal reflux disease|GERD]] | |||
* [[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> | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Serum [[gastrin]] concentration + [[secretin]] stimulation test | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Multiple or refractory [[Peptic ulcer|peptic ulcers]] | |||
* [[Chronic diarrhea]] | |||
* [[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> | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |High level of suspicion | |||
| align="left" style="background:#F5F5F5;" + | | |||
* [[Lethargy]] | |||
* Irregular [[Menstruation|menses]] | |||
* [[Abdominal pain]] | |||
* [[Constipation]] | |||
* [[Salivary gland]] hypertrophy | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Congenital chloridorrhea<ref name="WedenojaHãGlund2010">{{cite journal|last1=Wedenoja|first1=S.|last2=HãGlund|first2=P.|last3=Holmberg|first3=C.|title=Review article: the clinical management of congenital chloride diarrhoea|journal=Alimentary Pharmacology & Therapeutics|volume=31|issue=4|year=2010|pages=477–485|issn=02692813|doi=10.1111/j.1365-2036.2009.04197.x}}</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;" + |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;" + |↑ | |||
| 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 data | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Profuse [[diarrhea]] | |||
* [[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> | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |Physical exam + imaging | |||
| align="left" style="background:#F5F5F5;" + | | |||
* 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> | |||
| 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;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| align="center" style="background:#F5F5F5;" + |[[Colonoscopy]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
* [[Metabolic acidosis]] | |||
|- | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Gastrocystoplasty<ref name="KurzrockBaskin1998">{{cite journal|last1=Kurzrock|first1=Eric A.|last2=Baskin|first2=Laurence S.|last3=Kogan|first3=Barry A.|title=GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP|journal=The Journal of Urology|volume=160|issue=6|year=1998|pages=2182–2186|issn=00225347|doi=10.1016/S0022-5347(01)62289-4}}</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;" + |Nl | |||
| 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 to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |History of operation | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Hematuria-dysuria syndrome | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | |||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | |||
|- | |||
! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal origin | |||
! colspan="2" align="center" style="background:#DCDCDC;" + |Posthypercapnic state<ref name="BangaKhilnani2009">{{cite journal|last1=Banga|first1=Amit|last2=Khilnani|first2=G. C.|title=Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay|journal=COPD: Journal of Chronic Obstructive Pulmonary Disease|volume=6|issue=6|year=2009|pages=437–440|issn=1541-2555|doi=10.3109/15412550903341448}}</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;" + |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;" + |↓ | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Lab data | |||
| align="left" style="background:#F5F5F5;" + |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> | |||
| 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;" + |Nl | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Lab data | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |||
! 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;" + |− | |||
| 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;" + |Nl | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Lab data | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |||
! 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;" + |Nl | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↑ | |||
| 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;" + |Genetic testing | |||
| 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]] | |||
|- | |||
! 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;" + |Nl | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Genetic testing | |||
| align="left" style="background:#F5F5F5;" + | | |||
* Less severe | |||
* [[Constipation]] | |||
* [[Cramp|Muscle cramps]] and [[Muscle weakness|weakness]] | |||
* [[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> | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |Clinical + imaging | |||
| align="left" style="background:#F5F5F5;" + | | |||
* [[Chronic renal failure|Chronic kidney disease]] | |||
* 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> | |||
| 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;" + |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;" + |Genetic testing | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |||
! 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> | |||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |[[Biopsy]] | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! rowspan="6" 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> | |||
| 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;" + |↑ | |||
| 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 | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! | ! rowspan="2" align="center" style="background:#DCDCDC;" + |Hyperaldosteronism | ||
! | ! align="center" style="background:#DCDCDC;" + |Primary | ||
| 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;" + |↑ | |||
| 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 | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! align="center" style="background:#DCDCDC;" + |Secondary | |||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |Nl | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↓ | ||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! rowspan="2" align="center" style="background:#DCDCDC;" + |Adrenal enzyme defects | |||
| style="background: #F5F5F5; | ! align="center" style="background:#DCDCDC;" + |11β−Hydroxylase deficiency | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |Nl | ||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! align="center" style="background:#DCDCDC;" + |17α−Hydroxylase deficiency | |||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |Nl | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↓ | ||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Hypercalcemia/hypoparathyroidism | |||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | - | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↓ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↓ | ||
| 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;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | |||
| style="background: #F5F5F5; | ! colspan="2" align="center" style="background:#DCDCDC;" + |Cystic fibrosis | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + |− | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + |− | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + |− | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + |− | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + |− | ||
| style="background: #F5F5F5; | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↓ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |↑ | ||
| style="background: #F5F5F5 | | align="center" style="background:#F5F5F5;" + |Nl | ||
| 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;" + |Nl to ↑ | |||
| align="center" style="background:#F5F5F5;" + |Nl | |||
| align="center" style="background:#F5F5F5;" + |↓ | |||
| align="center" style="background:#F5F5F5;" + | | |||
| align="left" style="background:#F5F5F5;" + | | |||
|- | |- | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ||
| style="background: # | ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hydrogen loss | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Accumulation of base | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chloride depletion | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mineralocorticoid excess | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ||
| style="background: # | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Edema | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Toxic/ill | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dehydration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HCO<sub>3</sub><sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |paCO<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |O<sub>2</sub> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |K<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Na<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ca<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mg<sup>+</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Renin | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bun | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Cl<sup>−</sup> | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard diagnosis | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | |||
|} | |} | ||
<references /> | |||
==References== | ==References== |
Revision as of 12:46, 21 May 2018
Metabolic alkalosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
OR
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
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 | Genetic testing | |||
Gitelman’s syndrome[23] | + | - | - | + | - | - | - | - | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl | Genetic testing |
| ||
Renal artery stenosis[24] | + | - | + | - | - | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | Clinical + imaging |
| ||
Liddle syndrome[25] | + | - | - | + | - | - | - | - | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl | Genetic testing | |||
Renal tumors[26] | + | - | + | - | - | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | Biopsy | |||
Endocrine | Cushing's syndrome[27] | + | - | + | - | - | - | + | - | ↑ | + | ↑ | ↑ | Nl | ↓ | ↑ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | |||
Hyperaldosteronism | Primary | + | - | + | - | - | - | + | - | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | |||
Secondary | + | - | + | - | - | - | + | - | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | ||||
Adrenal enzyme defects | 11β−Hydroxylase deficiency | + | - | + | - | - | - | + | - | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | |||
17α−Hydroxylase deficiency | + | - | + | - | - | - | + | - | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | ||||
Hypercalcemia/hypoparathyroidism | + | - | + | - | - | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | ||||
Systemic | Cystic fibrosis | + | − | + | − | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | |||
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.
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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.
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- ↑ 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.
- ↑ 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.