Index of suspicion. Case 3. Hypokalemic periodic paralysis
This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while.
Gitelman disease associated with growth hormone deficiency, disturbances in vasopressin secretion and empty sella: a new hereditary renal tubular-pituitary syndrome?
Gitelman disease was diagnosed in two unrelated children with hypokalemic metabolic alkalosis and growth failure (a boy and a girl aged 7 mo and 9.5 y, respectively, at clinical presentation) on the basis of mutations detected in the gene encoding the thiazide-sensitive NaCl cotransporter of the distal convoluted tubule. GH deficiency was demonstrated by specific diagnostic tests in both children. Hypertonic saline infusion tests showed a partial vasopressin deficiency in the girl and delayed secretion of this hormone in the boy.
Evidence for Disturbed Regulation of Calciotropic Hormone Metabolism in Gitelman Syndrome
Little attention has been paid to interactions between circulating levels of calcium, PTH, and 1,25-dihydroxycholecalciferol [1,25(OH)2 D] and bone mineral density in primary renal magnesium deficiency. Plasma and urinary electrolytes, and circulating levels of calciotropic hormones were studied in 13 untreated patients with primary renal tubular hypokalemic alkalosis with hypocalciuria and magnesium deficiency. The blood ionized calcium concentration was significantly lower in patients than in controls.
Bartter syndrome is characterized by hyperplasia of the renal juxtaglomerular apparatus, hyperaldosteronism, and hypokalemic alkalosis. We report a case of Bartter syndrome associated with normal serum calcium levels and posterior choroidal calcification.
Obstetrics and Gynecology Clinics, Volume 27 Number 3 September 2000
Copyright 2000 W. B. Saunders Company, CURRENT REPRODUCTIVE ENDOCRINOLOGY
Advances in Diagnosis and Treatment
Bruce Kessel MD
Department of Obstetrics, Gynecology, and Women’s Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Premenstrual syndrome (PMS) is characterized by the occurrence of a constellation of symptoms temporally associated with the menstrual cycle. Symptoms of PMS include physical and mood changes that peak premenstrually and resolve shortly following the onset of menstrual bleeding. Historical descriptions of PMS are shrouded in mythology, and, previously, the scientific understanding of PMS was limited.
edical journals online will show a summary of medical articles. The summary is called an “abstract”. Sometimes just reading the abstract will tell you enough. Sometimes after reading an abstract you might want to read the full article. Then you can go to a medical library or public library and ask them to obtain the article for you. There are 54 abstracts listed, covering magnesium and ADD, asthma, allergies, heart disease, chronic fatigue, depression diabetes, fibromyalgia, high blood pressure, kidney stones, leg cramps, migraines, multiple sclerosis, premenstrual syndrome, pregnancy, preemies, seizures, SIDS, and stress.
Results from Mail in Survey
One thing I have noticed in doing the surveys is that the older a person gets the more symptoms they have. A small child has very few which is probably because mom does not know what that child is truly feeling. In the teens the symptoms increase but only slightly. In the 20′s a slight increase and then in the 30′s the person has 10 or more symptoms. By the 40′s the person has most of the symptoms listed below. This could be because the person has had it longer so they are more aware of their symptoms or it could be that as we age the symptoms will increase.
Definition: Deposits of calcium (in the form of calcium phosphate and calcium oxalate) in the kidney, a process that may result in reduced kidney function.
Nephrocalcinosis can be caused by several conditions including: the excess excretion of calcium by the kidney, renal tubular acidosis, medullary sponge kidney, hypercalcemia (high calcium levels in the blood), renal cortical necrosis, and tuberculosis.
Dehydration is a condition in which the body doesn’t have enough water to function properly. Your child’s body can lose a lot of water if he or she has diarrhea, is vomiting, or has been exercising for a long time without having anything to drink. If water is not adequately replaced in the body, complications can include decreased activity, weakness, electrolyte imbalances, and, in cases of extreme dehydration, death.
Infants and young children are at greatest risk for dehydration. Sick children may become more dehydrated if they do not want to drink because their stomach hurts or if they are very weak. Children with Bartter’s and Gitelman’s Syndrome can dehydrate very quickly, more so than the normal child.
One of the problems that Bartter and Gitelman patients can have is dehydration because the kidney does not have the ability to concentrate urine. Therefore you lose more fluid than normal and need to take in more fluid than normal. In hot weather it is even more important to be aware of the symptoms of dehydration and what you can do to prevent it and treat it. This is especially important for children, the elderly and patients with Bartters and Gitelmans Syndrome.