Severe Metabolic Alkalosis in a Patient with Growth Retardation, Malnutrition and Induced Vomiting
Konstantinos S. Mavromatidis *
Renal Unit, Dimokrition, Komotini, Thrace, Greece.
Gioulia V. Romanidou
Renal Department, General Hospital of Komotini, Thrace, Greece.
Athanasios V. Bakaloudis
Renal Department, General Hospital of Komotini, Thrace, Greece.
Anastasia K. Georgoulidou
Renal Department, General Hospital of Komotini, Thrace, Greece.
Panagiota M. Zinapi
Renal Department, General Hospital of Komotini, Thrace, Greece.
*Author to whom correspondence should be addressed.
Abstract
Metabolic alkalosis is maybe the most common and serious acid-base disorder in clinical practice (the life of any patient with pH>7.55 is at serious risk). It is accompanied by hypochloremia and hypokalemia. Its most common cause is the use of diuretics, the use of which is quite common, but also in the presence of vomiting, although there are rare cases due to hereditary diseases (Bartter, Gitelman). All these conditions are characterized by low blood pressure. However, there are also diseases with hypertension, which appear themselves with the same characteristics (conditions with intense mineralocorticoid action). A patient with impaired growth (short stature and underweight) is presented, with severe metabolic alkalosis, hypokalemia, hypochloremia, hyponatremia and hypotension, which concealed the presence of induced vomiting from her history. The case is described and a differential diagnosis from Bartter syndrome is made.
Keywords: Metabolic alkalosis, induced vomiting, Bartter syndrome, hypokalemia, hypochloremia
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