Hi all!
We got a 3yo female DSH, 4 weeks post partum, presented cervical ventroflexion, and generalized muscular weakness (cannot walk), tachypnea.
Bloodwork hypokalemia of 3.2, and regenerativve anemia, the rest of the Biochem and Hem are unremarkable.
On ultrasound bilateral adrenomegaly was noted (left 0.68cm, right 0.72cm width), severe gastric dilation with large amount of ingesta and no peristalsis, small amount of abdominal effusion (not enough for sampling).
Hi all!
We got a 3yo female DSH, 4 weeks post partum, presented cervical ventroflexion, and generalized muscular weakness (cannot walk), tachypnea.
Bloodwork hypokalemia of 3.2, and regenerativve anemia, the rest of the Biochem and Hem are unremarkable.
On ultrasound bilateral adrenomegaly was noted (left 0.68cm, right 0.72cm width), severe gastric dilation with large amount of ingesta and no peristalsis, small amount of abdominal effusion (not enough for sampling).
With hypokalemia (although not extremely low) and cervical ventroflexion the first thing we considered was Conn’s syndrome, however can you get hyperaldosteronism in bilateral adrenomegaly and in such a young patient and with not a severe hypokalemia? Which other differentials should we consider?
Thanks for any help
Veronica
Comments
Potassium not that low but
Potassium not that low but remember that the majority of potassium is intra-cellular. One study showed the mean potassium concentration at presentation to be 2.5 mEq/L. The youngest report age that I could find was 5 years. Another possiblity for the signs would be organphosphate/carbamate toxicity, thiamine deficiency, myositis, neuropathy, myasthenia gravis
Potassium not that low but
Potassium not that low but remember that the majority of potassium is intra-cellular. One study showed the mean potassium concentration at presentation to be 2.5 mEq/L. The youngest report age that I could find was 5 years. Another possiblity for the signs would be organphosphate/carbamate toxicity, thiamine deficiency, myositis, neuropathy, myasthenia gravis
Thanks Remo!
Yes i though the
Thanks Remo!
Yes i though the potassium is not that low, and the age (too young). Thanks for the differentials.
Would you still consider K supplementation even if it is not significantly low? I guess even if we do it we will not see much improvement anyway.
Thanks again 🙂
Thanks Remo!
Yes i though the
Thanks Remo!
Yes i though the potassium is not that low, and the age (too young). Thanks for the differentials.
Would you still consider K supplementation even if it is not significantly low? I guess even if we do it we will not see much improvement anyway.
Thanks again 🙂
Still need to supplement
Still need to supplement potassium and may get a good improvement.
Still need to supplement
Still need to supplement potassium and may get a good improvement.