Hypokalemia differential diagnosis: Difference between revisions

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! rowspan="7" style="background: #DCDCDC; text-align: center;" |[[Renal]] and [[adrenal disorders]]
! rowspan="7" style="background: #DCDCDC; text-align: center;" |[[Renal]] and [[adrenal disorders]]
! style="background: #DCDCDC; text-align: center;" |[[Diuretic use]]<ref name="pmid8199766">{{cite journal |vauthors=Bourke E, Delaney V |title=Prevention of hypokalemia caused by diuretics |journal=Heart Dis Stroke |volume=3 |issue=2 |pages=63–7 |date=1994 |pmid=8199766 |doi= |url=}}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Loop diuretics|Loop diuretic use]]<ref name="pmid8199766">{{cite journal |vauthors=Bourke E, Delaney V |title=Prevention of hypokalemia caused by diuretics |journal=Heart Dis Stroke |volume=3 |issue=2 |pages=63–7 |date=1994 |pmid=8199766 |doi= |url=}}</ref>
!+/-
!+/-
!-
!-
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!-
!-
!-
!-
!History
!History of medication use
!-
!-
|-
|-
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!Hypodense unilateral [[Adrenal Mass|adrenal macroadenoma]] (>1 cm) 
!Hypodense unilateral [[Adrenal Mass|adrenal macroadenoma]] (>1 cm) 
!'''[[Aldosterone|PAC]]:[[Plasma renin activity|PRA]] ratio'''
!'''[[Aldosterone|PAC]]:[[Plasma renin activity|PRA]] ratio'''
![[Mood disturbances|Mood disturbance]], [[Paresthesia]], [[Muscle cramps]]
![[Mood disturbances|Mood disturbance]], [[Paresthesias|paresthesia]], [[muscle cramps]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Cushing syndrome]]<ref name="pmid12381548">{{cite journal |vauthors=Torpy DJ, Mullen N, Ilias I, Nieman LK |title=Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases |journal=Ann. N. Y. Acad. Sci. |volume=970 |issue= |pages=134–44 |date=September 2002 |pmid=12381548 |doi= |url=}}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Cushing syndrome]]<ref name="pmid12381548">{{cite journal |vauthors=Torpy DJ, Mullen N, Ilias I, Nieman LK |title=Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases |journal=Ann. N. Y. Acad. Sci. |volume=970 |issue= |pages=134–44 |date=September 2002 |pmid=12381548 |doi= |url=}}</ref>
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!-
!-
!↑
!↑
![[Plethora|Facial plethora]], [[Striae|Purple striae]]
![[Plethora|Facial plethora]], [[Striae|purple striae]]
!+
!+
![[Metabolic alkalosis]]
![[Metabolic alkalosis]]
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!-
!-
!'''Urinary free [[cortisol]] (24-hour)'''
!'''Urinary free [[cortisol]] (24-hour)'''
!Dorsicocervical [[fat pad]], [[Obesity]], [[Hirsutism]]
!Dorsicocervical [[fat pad]], [[obesity]], [[hirsutism]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Hemodialysis]]<ref name="pmid23946760">{{cite journal| author=Choi HY, Ha SK| title=Potassium balances in maintenance hemodialysis. | journal=Electrolyte Blood Press | year= 2013 | volume= 11 | issue= 1 | pages= 9-16 | pmid=23946760 | doi=10.5049/EBP.2013.11.1.9 | pmc=3741441 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23946760  }}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Hemodialysis]]<ref name="pmid23946760">{{cite journal| author=Choi HY, Ha SK| title=Potassium balances in maintenance hemodialysis. | journal=Electrolyte Blood Press | year= 2013 | volume= 11 | issue= 1 | pages= 9-16 | pmid=23946760 | doi=10.5049/EBP.2013.11.1.9 | pmc=3741441 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23946760  }}</ref>
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!-
!-
!Laboratory findings
!Laboratory findings
![[Mental retardation]], [[Sensorineural hearing loss]]
![[Mental retardation]], [[sensorineural hearing loss]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Gitelman syndrome]]<ref name="pmid18667063">{{cite journal| author=Knoers NV, Levtchenko EN| title=Gitelman syndrome. | journal=Orphanet J Rare Dis | year= 2008 | volume= 3 | issue=  | pages= 22 | pmid=18667063 | doi=10.1186/1750-1172-3-22 | pmc=2518128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18667063  }}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Gitelman syndrome]]<ref name="pmid18667063">{{cite journal| author=Knoers NV, Levtchenko EN| title=Gitelman syndrome. | journal=Orphanet J Rare Dis | year= 2008 | volume= 3 | issue=  | pages= 22 | pmid=18667063 | doi=10.1186/1750-1172-3-22 | pmc=2518128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18667063  }}</ref>
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!-
!-
!Laboratory findings
!Laboratory findings
![[Growth retardation]], [[Tetany]], [[Muscle cramps|Muscle cramp]]
![[Growth retardation]], [[tetany]], [[muscle cramp]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Liddle syndrome]]<ref name="pmid29534496">{{cite journal |vauthors=Tetti M, Monticone S, Burrello J, Matarazzo P, Veglio F, Pasini B, Jeunemaitre X, Mulatero P |title=Liddle Syndrome: Review of the Literature and Description of a New Case |journal=Int J Mol Sci |volume=19 |issue=3 |pages= |date=March 2018 |pmid=29534496 |pmc=5877673 |doi=10.3390/ijms19030812 |url=}}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Liddle syndrome]]<ref name="pmid29534496">{{cite journal |vauthors=Tetti M, Monticone S, Burrello J, Matarazzo P, Veglio F, Pasini B, Jeunemaitre X, Mulatero P |title=Liddle Syndrome: Review of the Literature and Description of a New Case |journal=Int J Mol Sci |volume=19 |issue=3 |pages= |date=March 2018 |pmid=29534496 |pmc=5877673 |doi=10.3390/ijms19030812 |url=}}</ref>
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!-
!-
!Clinical findings
!Clinical findings
![[Orthostatic hypotension]], [[Bradycardia]]
![[Orthostatic hypotension]], [[bradycardia]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Vomiting]]<ref name="pmid22169581">{{cite journal |vauthors=Cheungpasitporn W, Suksaranjit P, Chanprasert S |title=Pathophysiology of vomiting-induced hypokalemia and diagnostic approach |journal=Am J Emerg Med |volume=30 |issue=2 |pages=384 |date=February 2012 |pmid=22169581 |doi=10.1016/j.ajem.2011.10.005 |url=}}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Vomiting]]<ref name="pmid22169581">{{cite journal |vauthors=Cheungpasitporn W, Suksaranjit P, Chanprasert S |title=Pathophysiology of vomiting-induced hypokalemia and diagnostic approach |journal=Am J Emerg Med |volume=30 |issue=2 |pages=384 |date=February 2012 |pmid=22169581 |doi=10.1016/j.ajem.2011.10.005 |url=}}</ref>
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!-
!-
!Clinical findings
!Clinical findings
!Dry [[mucous membranes]], [[Lethargy]]
!Dry [[mucous membranes]], [[lethargy]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |Severe [[diarrhea]]<ref name="pmid28580600">{{cite journal |vauthors=Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M |title=Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature |journal=Neurogastroenterol. Motil. |volume=29 |issue=11 |pages= |date=November 2017 |pmid=28580600 |doi=10.1111/nmo.13120 |url=}}</ref>
! style="background: #DCDCDC; text-align: center;" |Severe [[diarrhea]]<ref name="pmid28580600">{{cite journal |vauthors=Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M |title=Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature |journal=Neurogastroenterol. Motil. |volume=29 |issue=11 |pages= |date=November 2017 |pmid=28580600 |doi=10.1111/nmo.13120 |url=}}</ref>
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!-
!-
!Clinical findings
!Clinical findings
!Dry [[mucous membranes]], [[Lethargy]]
!Dry [[mucous membranes]], [[lethargy]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Villous adenoma]]<ref name="pmid24199207">{{cite journal| author=Sanchez Garcia S, Villarejo Campos P, Manzanares Campillo Mdel C, Gil Rendo A, Muñoz Atienza V, García Santos EP et al.| title=Hypersecretory villous adenoma as the primary cause of an intestinal intussusception and McKittrick-Wheelock syndrome. | journal=Can J Gastroenterol | year= 2013 | volume= 27 | issue= 11 | pages= 621-2 | pmid=24199207 | doi= | pmc=3816940 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24199207  }}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Villous adenoma]]<ref name="pmid24199207">{{cite journal| author=Sanchez Garcia S, Villarejo Campos P, Manzanares Campillo Mdel C, Gil Rendo A, Muñoz Atienza V, García Santos EP et al.| title=Hypersecretory villous adenoma as the primary cause of an intestinal intussusception and McKittrick-Wheelock syndrome. | journal=Can J Gastroenterol | year= 2013 | volume= 27 | issue= 11 | pages= 621-2 | pmid=24199207 | doi= | pmc=3816940 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24199207  }}</ref>
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!-
!-
!↓
!↓
![[Facial flushing]], [[Skin rash]]
![[Facial flushing]], [[skin rash]]
!+
!+
!Normal
!Normal
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!-
!-
![[Psychological analysis|Psychological interview]]
![[Psychological analysis|Psychological interview]]
! [[Parotid gland]] enlargement, [[Lanugo]]-like hair
! [[Parotid gland]] enlargement, [[lanugo]]-like hair
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Anorexia nervosa]]<ref name="pmid21670105">{{cite journal| author=Liang CC, Yeh HC| title=Hypokalemic nephropathy in anorexia nervosa. | journal=CMAJ | year= 2011 | volume= 183 | issue= 11 | pages= E761 | pmid=21670105 | doi=10.1503/cmaj.101790 | pmc=3153553 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21670105  }}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Anorexia nervosa]]<ref name="pmid21670105">{{cite journal| author=Liang CC, Yeh HC| title=Hypokalemic nephropathy in anorexia nervosa. | journal=CMAJ | year= 2011 | volume= 183 | issue= 11 | pages= E761 | pmid=21670105 | doi=10.1503/cmaj.101790 | pmc=3153553 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21670105  }}</ref>
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!-
!-
!↓
!↓
![[Xerosis]], [[Telogen effluvium|Hair effluvium]]
![[Xerosis]], [[Telogen effluvium|hair effluvium]]
!-
!-
!Normal
!Normal
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!-
!-
![[Psychological analysis|Psychological interview]]
![[Psychological analysis|Psychological interview]]
![[Orthostatic hypotension]], [[Bradycardia]]
![[Orthostatic hypotension]], [[bradycardia]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Hypokalemic periodic paralysis]]<ref name="urlHypokalemic periodic paralysis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/6729/hypokalemic-periodic-paralysis |title=Hypokalemic periodic paralysis &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Hypokalemic periodic paralysis]]<ref name="urlHypokalemic periodic paralysis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/6729/hypokalemic-periodic-paralysis |title=Hypokalemic periodic paralysis &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
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!-
!-
!Laboratory findings
!Laboratory findings
![[Paralysis|Paralytic episodes]], [[Arrhythmias]]
![[Paralysis|Paralytic episodes]], [[arrhythmias]]
|-
|-
! rowspan="6" style="background: #DCDCDC; text-align: center;" |[[Systemic diseases]]
! rowspan="6" style="background: #DCDCDC; text-align: center;" |[[Systemic diseases]]
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!+
!+
!Normal or ↓
!Normal or ↓
![[Icterus]], [[Caput medusae|Caput medusa]]
![[Icterus]], [[caput medusae]]
!+
!+
![[Metabolic alkalosis]]
![[Metabolic alkalosis]]
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!-
!-
!Clinical findings
!Clinical findings
![[Digital clubbing]], [[Gynecomastia]]
![[Digital clubbing]], [[gynecomastia]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Diabetic ketoacidosis]]<ref name="pmid25430801">{{cite journal| author=Davis SM, Maddux AB, Alonso GT, Okada CR, Mourani PM, Maahs DM| title=Profound hypokalemia associated with severe diabetic ketoacidosis. | journal=Pediatr Diabetes | year= 2016 | volume= 17 | issue= 1 | pages= 61-5 | pmid=25430801 | doi=10.1111/pedi.12246 | pmc=4896141 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25430801  }}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Diabetic ketoacidosis]]<ref name="pmid25430801">{{cite journal| author=Davis SM, Maddux AB, Alonso GT, Okada CR, Mourani PM, Maahs DM| title=Profound hypokalemia associated with severe diabetic ketoacidosis. | journal=Pediatr Diabetes | year= 2016 | volume= 17 | issue= 1 | pages= 61-5 | pmid=25430801 | doi=10.1111/pedi.12246 | pmc=4896141 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25430801  }}</ref>
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![[Metabolic acidosis]]
![[Metabolic acidosis]]
![[Ketonuria]]
![[Ketonuria]]
!↑Serum [[ketone]], ↑[[Blood glucose]]
!↑Serum [[ketone]], ↑ [[blood glucose]]
!-
!-
!-
!-
!Laboratory findings
!Laboratory findings
!Dry [[mucous membranes]], [[Shock]]
!Dry [[mucous membranes]], [[shock]]
|-
|-
! style="background: #DCDCDC; text-align: center;" |[[Hypomagnesemia]]<ref name="pmid17804670">{{cite journal |vauthors=Huang CL, Kuo E |title=Mechanism of hypokalemia in magnesium deficiency |journal=J. Am. Soc. Nephrol. |volume=18 |issue=10 |pages=2649–52 |date=October 2007 |pmid=17804670 |doi=10.1681/ASN.2007070792 |url=}}</ref>
! style="background: #DCDCDC; text-align: center;" |[[Hypomagnesemia]]<ref name="pmid17804670">{{cite journal |vauthors=Huang CL, Kuo E |title=Mechanism of hypokalemia in magnesium deficiency |journal=J. Am. Soc. Nephrol. |volume=18 |issue=10 |pages=2649–52 |date=October 2007 |pmid=17804670 |doi=10.1681/ASN.2007070792 |url=}}</ref>
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!-
!-
!↓
!↓
![[Vesicle]] and bullae, [[Erythema]]
![[Vesicle]] and bullae, [[erythema]]
!+
!+
!Normal
!Normal

Revision as of 15:29, 30 May 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Differentiating Causes of Hypokalemia

Differentiating the diseases that can cause hypokalemia is as following table:

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging
Fatigue Fever Urinary symptoms Blood Pressure Skin lesions Edema ABG Urinalysis Other Ultrasonography CT scan
Polyuria Oliguria Nocturia
Renal and adrenal disorders Loop diuretic use[1] +/- - + - +/- - + Metabolic alkalosis K Na - - History of medication use -
Primary hyperaldosteronism[2] + - + - + Facial flushing - Metabolic alkalosis K, ↓Na PRA, ↑PAC, ↓Na Unilateral adrenal hyperplasia Hypodense unilateral adrenal macroadenoma (>1 cm)  PAC:PRA ratio Mood disturbance, paresthesia, muscle cramps
Cushing syndrome[3] + +/- +/- - - Facial plethora, purple striae + Metabolic alkalosis Glucosuria BS Unilateral adrenal hyperplasia - Urinary free cortisol (24-hour) Dorsicocervical fat pad, obesity, hirsutism
Hemodialysis[4] +/- +/- +/- - - Normal Pustular lesions - Metabolic alkalosis Normal Na - - History Carpal tunnel syndrome
Bartter syndrome[5] + - + - +/- Normal or ↓ - - Metabolic alkalosis K, ↑Ca, ↑Cl - - - Laboratory findings Mental retardation, sensorineural hearing loss
Gitelman syndrome[6] + - + - + Normal - - Metabolic alkalosis K, ↓Ca, ↑Cl - - - Laboratory findings Growth retardation, tetany, muscle cramp
Liddle syndrome[7] - - +/- - - - +/- Metabolic alkalosis K, ↓Na PRA, ↓PAC - - Laboratory findings Pseudohyperaldosteronism
Gastrointestinal disorders GI bleeding[8] + - - + - - - Normal Normal Anemia - - Clinical findings Orthostatic hypotension, bradycardia
Vomiting[9] + - - + - - - Metabolic alkalosis Cl <20 mEq/L - - - Clinical findings Dry mucous membranes, lethargy
Severe diarrhea[10] + - - + - - - Metabolic alkalosis K<20 mEq/L - - - Clinical findings Dry mucous membranes, lethargy
Villous adenoma[11] + - - + - - - Normal K and Cl <20 mEq/L Anemia - - Colonoscopy Hematochezia
VIPoma[12] + +/- - + - Facial flushing, skin rash + Normal K<20 mEq/L Stool osmolar gap <50 mOsm/kg Endoscopic ultrasound for VIPomas of 2-3 mm Pancreatic VIPomas >3 cm Laboratory findings Weight loss
Neuropsychiatric disorders Primary polydipsia[13] - - + - + Normal - +/- Normal Urine osmolarity Na - - Water restriction test Psychosis
Central diabetes insipidus[14] + - + - + Normal or ↓ - - Normal Urine osmolarity Na - - Water restriction test Ischemic encephalopathy
Bulimia nervosa[15] - - - +/- - Normal or ↓ Asteatotic skin Carotenodermia - Normal K, ↓Cl - - - Psychological interview  Parotid gland enlargement, lanugo-like hair
Anorexia nervosa[16] + - - +/- - Xerosis, hair effluvium - Normal K, ↓Cl - - - Psychological interview Orthostatic hypotension, bradycardia
Hypokalemic periodic paralysis[17] + - - - +/- Normal or ↓ - +/- Metabolic alkalosis K<20 mEq/L Thyrotoxicosis, ↓Mg, ↓Ph - - Laboratory findings Paralytic episodes, arrhythmias
Systemic diseases Hypothermia[18] - - - +/- - Normal Frostbite - Normal Normal - - - Clinical findings Impaired mental state
Alcoholism[19] + +/- + - + Normal or ↓ Icterus, caput medusae + Metabolic alkalosis Ketonuria Anemia - - Clinical findings Digital clubbing, gynecomastia
Diabetic ketoacidosis[20] + +/- + - + Xerosis - Metabolic acidosis Ketonuria ↑Serum ketone, ↑ blood glucose - - Laboratory findings Dry mucous membranes, shock
Hypomagnesemia[21] + - - +/- - Normal - +/- Metabolic alkalosis - Ca - - Laboratory findings Trousseau and Chvostek signs
Burns[22] +/- - - + - Vesicle and bullae, erythema + Normal - Acute phase reactant - - Clinical findings Dehydration
Cystic fibrosis[23] +/- +/- - +/- - Early aquagenic skin wrinkling +/- Normal - - Pancreatitis Pulmonary infiltration Sweat chloride test Pancreatic insufficiency

References

  1. Bourke E, Delaney V (1994). "Prevention of hypokalemia caused by diuretics". Heart Dis Stroke. 3 (2): 63–7. PMID 8199766.
  2. Wu C, Xin J, Xin M, Zou H, Jing L, Zhu C; et al. (2016). "Hypokalemic myopathy in primary aldosteronism: A case report". Exp Ther Med. 12 (6): 4064–4066. doi:10.3892/etm.2016.3864. PMC 5228118. PMID 28101185.
  3. Torpy DJ, Mullen N, Ilias I, Nieman LK (September 2002). "Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases". Ann. N. Y. Acad. Sci. 970: 134–44. PMID 12381548.
  4. Choi HY, Ha SK (2013). "Potassium balances in maintenance hemodialysis". Electrolyte Blood Press. 11 (1): 9–16. doi:10.5049/EBP.2013.11.1.9. PMC 3741441. PMID 23946760.
  5. Hebert SC (September 2003). "Bartter syndrome". Curr. Opin. Nephrol. Hypertens. 12 (5): 527–32. doi:10.1097/01.mnh.0000088732.87142.43. PMID 12920401.
  6. Knoers NV, Levtchenko EN (2008). "Gitelman syndrome". Orphanet J Rare Dis. 3: 22. doi:10.1186/1750-1172-3-22. PMC 2518128. PMID 18667063.
  7. Tetti M, Monticone S, Burrello J, Matarazzo P, Veglio F, Pasini B, Jeunemaitre X, Mulatero P (March 2018). "Liddle Syndrome: Review of the Literature and Description of a New Case". Int J Mol Sci. 19 (3). doi:10.3390/ijms19030812. PMC 5877673. PMID 29534496.
  8. Asmar A, Mohandas R, Wingo CS (2012). "A physiologic-based approach to the treatment of a patient with hypokalemia". Am J Kidney Dis. 60 (3): 492–7. doi:10.1053/j.ajkd.2012.01.031. PMC 4776048. PMID 22901631.
  9. Cheungpasitporn W, Suksaranjit P, Chanprasert S (February 2012). "Pathophysiology of vomiting-induced hypokalemia and diagnostic approach". Am J Emerg Med. 30 (2): 384. doi:10.1016/j.ajem.2011.10.005. PMID 22169581.
  10. Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M (November 2017). "Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature". Neurogastroenterol. Motil. 29 (11). doi:10.1111/nmo.13120. PMID 28580600.
  11. Sanchez Garcia S, Villarejo Campos P, Manzanares Campillo Mdel C, Gil Rendo A, Muñoz Atienza V, García Santos EP; et al. (2013). "Hypersecretory villous adenoma as the primary cause of an intestinal intussusception and McKittrick-Wheelock syndrome". Can J Gastroenterol. 27 (11): 621–2. PMC 3816940. PMID 24199207.
  12. Krejs GJ (May 1987). "VIPoma syndrome". Am. J. Med. 82 (5B): 37–48. PMID 3035922.
  13. Gill M, McCauley M (2015). "Psychogenic polydipsia: the result, or cause of, deteriorating psychotic symptoms? A case report of the consequences of water intoxication". Case Rep Psychiatry. 2015: 846459. doi:10.1155/2015/846459. PMC 4320790. PMID 25688318.
  14. Nguyen FN, Kar JK, Verduzco-Gutierrez M, Zakaria A (2014). "A case of hypokalemic paralysis in a patient with neurogenic diabetes insipidus". Neurohospitalist. 4 (2): 90–3. doi:10.1177/1941874413495702. PMC 3975788. PMID 24707338.
  15. Rushing JM, Jones LE, Carney CP (2003). "Bulimia Nervosa: A Primary Care Review". Prim Care Companion J Clin Psychiatry. 5 (5): 217–224. PMC 419300. PMID 15213788.
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