Hypochloremia
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Hypochloremia (or Hypochloraemia) is an electrolyte disturbance whereby there is an abnormally depleted level of the chloride ion in the blood. It rarely occurs in the absence of other abnormalities. If it occurs together with metabolic alkalosis (decreased blood acidity) it is often due to vomiting.
Normal values of Chloride: 99-111 mEq/L (99-111 mmol/L)
Primary anion of extracellular fluid compartment; aids in maintenance of acid-base balance.
Causes
Complete Differential Diagnosis of the Causes of Hypochloremia
- ACTH-secreting tumors
- Adrenal insufficiency
- Bulimia nervosa
- Burns
- Congestive heart failure
- Cushing's syndrome
- Diabetic coma
- Diarrhea
- Drugs
- Excessive sweating
- Gastric suction
- Hyperaldosteronism
- Hyponatremia
- Overconsumption of licorice
- Pseudohyponatremia
- Renal failure
- Respiratory losses
- Salt-losing nephritis
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Vomiting
Complete Differential Diagnosis of the Causes of Hypochloremia
(By organ system)
Cardiovascular | Congestive heart failure |
Chemical / poisoning | No underlying causes |
Dermatologic | Excessive sweating |
Drug Side Effect | Aldosterone, Antacid abuse, Bicarbonate containing medication, Corticosteroids, Corticotropin, Laxatives, Loop diuretics, Thiazide diuretics |
Ear Nose Throat | No underlying causes |
Endocrine | ACTH-secreting tumors, Adrenal insufficiency, Cushing's syndrome, Diabetic coma, Hyperaldosteronism, Hyponatremia, Pseudohyponatremia, Syndrome of inappropriate antidiuretic hormone secretion (SIADH) |
Environmental | No underlying causes |
Gastroenterologic | Bulimia nervosa, Diarrhea, Gastric suction, Gastrocolic fistula, Gastroesopahgeal reflux disease, Pyloric stenosis, Villous adenoma, Vomiting |
Genetic | Cystic fibrosis, Bartter's syndrome |
Hematologic | No underlying causes |
Iatrogenic | Excessive saline infusion, Massive blood transfusion, Gastric suction |
Infectious Disease | No underlying causes |
Musculoskeletal / Ortho | No underlying causes |
Neurologic | Excessive sweating |
Nutritional / Metabolic | Low sodium diet, Metabolic alkalosis, Milk alkali syndrome, Overconsumption of licorice |
Obstetric/Gynecologic | No underlying causes |
Oncologic | ACTH-secreting tumors |
Opthalmologic | No underlying causes |
Overdose / Toxicity | |
Psychiatric | Bulimia nervosa |
Pulmonary | Respiratory losses, Hypoventilation |
Renal / Electrolyte | Hyponatremia, Renal failure, Salt-losing nephritis, Bartter's syndrome |
Rheum / Immune / Allergy | No underlying causes |
Sexual | No underlying causes |
Trauma | Burns |
Urologic | Renal failure |
Miscellaneous | No underlying causes |
References
External links
Template:Fluid, electrolyte, acid base metabolic pathology
Template:Endocrine, nutritional and metabolic pathology