1/9. refeeding syndrome.CASE REPORT: An elderly woman with poor nutritional intake developed profound hypophosphataemia and hypokalaemia following the institution of nasogastric feeding. DISCUSSION: refeeding syndrome is well recognized in certain undernourished groups of patients, but may not be so well known to physicians looking after elderly patients, whose nutritional status may be more deficient than is originally apparent.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/9. Licorice consumption causing severe hypokalemic paralysis.Hypokalemic paralysis due to licorice consumption is extremely rare, with only 40 cases in the English literature describing paralysis secondary to exposure to licorice in candies, medications, chewing tobacco, and herbal preparations. We describe a patient who suffered life-threatening hypokalemic paralysis caused by consumption of licorice in the form of a tea sweetener superimposed on long-term consumption of licorice candy. Aggressive fluid and potassium replenishment produced complete and lasting recovery. To our knowledge, this is the first report of hypokalemic paralysis due to exposure to licorice as a tea sweetener, a common custom among the Arab population. The case emphasizes the importance of considering patients' cultural backgrounds and local customs, which often may lead the treating physician to the correct clinical diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/9. Thyrotoxic hypokalaemic paralysis in a pregnant Afro-Caribbean woman. A case report and review of the literature.This paper reports the case of a 21-year-old Afro-Caribbean pregnant woman with hyperthyroidism and hypokalaemic quadriparesis and reviews the literature on the topic. Thyrotoxic periodic paralysis is a very rare condition in the Caribbean. This case reminds West Indian physicians to consider this rare condition in any patient that presents with paralysis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/9. A case report and review of hypokalemic paralysis secondary to renal tubular acidosis.A 5-year-old girl with distal renal tubular acidosis (RTA) and hypokalemic muscle paralysis is reported. RTA is a known cause of hypokalemia, but in spite of the presence of persistent hypokalemia muscular paralysis is uncommon, rarely described in children, and the onset of paralysis may initially be misinterpreted particularly if the patient is attended by a physician who is not a pediatric nephrologist. Therefore parents must be informed about this possibility. Still, as the clinical appearance of hypokalemic paralysis is quite similar to familial hypokalemic periodic paralysis, and because the emergent and prophylactic treatment of the two disorders are quite different, we discuss the diagnostic evaluation and the treatment for both of them.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/9. Severe hypokalaemic paralysis and rhabdomyolysis due to ingestion of liquorice.Chronic ingestion of liquorice induces a syndrome with findings similar to those in primary hyperaldosteronism. We describe a patient who, with a plasma K of 1.8 mmol/l, showed a paralysis and severe rhabdomyolysis after the habitual consumption of natural liquorice. Liquorice has become widely available as a flavouring agent in foods and drugs. It is important for physicians to keep liquorice consumption in mind as a cause for hypokalaemic paralysis and rhabdomyolysis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/9. diagnosis of adenomatous primary aldosteronism in a patient with severe hypertension.BACKGROUND: A 27-year-old woman presented to her primary-care physician with severe hypertension after complaining of fatigue over the preceding months. She was otherwise asymptomatic. She was referred to a hypertension clinic and was found to be hypokalemic. She was immediately commenced on amlodipine, with atenolol added 2 weeks later. After 4 weeks of this drug therapy, her hypertension persisted and investigations to exclude secondary causes of hypertension were performed. INVESTIGATIONS: aldosterone and renin levels were measured under controlled conditions and the results expressed as an aldosterone-to-renin ratio. CT of the adrenal glands was also performed. diagnosis: Adenomatous primary aldosteronism (Conn's syndrome). MANAGEMENT: The patient was initially treated with spironolactone before undergoing a laparoscopic left adrenalectomy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/9. Acute respiratory arrest due to hypokalemia.An uncommon but treatable etiology of acute respiratory failure is hypokalemia. A 36-year-old woman with previously undiagnosed distal renal tubular acidosis presented with foot and ankle swelling that was being treated with furosemide. She had been seen by three physicians within 24 hours and was diagnosed as having depression or hysterical conversion reaction. Her symptoms progressed to respiratory arrest. Initial treatment consisted of administering 40 mEq of KCl over one hour through a central venous line. The patient recovered rapidly and was weaned off a respirator within 24 hours of admission.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/9. Occult causes of hypokalemia.Most causes of hypokalemia are obvious from the clinical picture and the values for plasma electrolytes. In cases with obscure etiology, a pretreatment estimation of urinary potassium and chloride often helps lead the clinician into new and fruitful avenues of clinical investigation. Here we present four cases of hypokalemia in which the pathogenesis was initially enigmatic but was clarified somewhat by the determination of the urinary electrolytes. These simple, inexpensive investigations were initiated by the clinical chemistry laboratory in each case. The results encouraged the physicians to consider further clinical investigations, which led to a definitive diagnosis, before invoking expensive hormonal analyses.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/9. Hypokalaemic thyrotoxic periodic paralysis: case report and review of an Oriental syndrome.Presentations of acute systemic weakness are rare and appear dramatic and frightening to both patients and physicians. Aetiologies are multifactorial and diverse. morbidity and mortality are associated with the unrecognized disease. One of the underlying disorders is hypokalaemic thyrotoxic periodic paralysis (HTPP), an uncommon disorder. HTPP is characterized by periodic occurrences of muscle weakness during attacks of hyperthyroidism and appears predominantly in Orientals. This article describes a patient of Chinese origin with hyperthyroidism and attacks of paralysis and considers several problems: a lack of familiarity with the syndrome, increasing numbers of patients with this disease in European hospitals as a result of migration of populations, and the importance of patient compliance in therapeutic management. Finally, a review of the literature concerning presentation, differential diagnosis, pathophysiology, and therapeutic management is provided.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |