Hypokalemia differential diagnosis: Difference between revisions

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Revision as of 20:06, 18 May 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differentiating Causes of Hypokalemia

Differentiating the diseases that can cause hypokalemia is as following:

Diseases		Clinical manifestations								Para-clinical findings					Gold standard	Additional findings
		Symptoms					Physical examination			Para-clinical findings
		Symptoms					Physical examination			Lab Findings			Imaging
		Fatigue	Fever	Urinary symptoms			Blood Pressure	Skin lesions	Edema	ABG	Urinalysis	Other	Ultrasonography	CT scan
		Fatigue	Fever	Polyuria	Oliguria	Nocturia	Blood Pressure	Skin lesions	Edema	ABG	Urinalysis	Other	Ultrasonography	CT scan
Renal and adrenal disorders	Bartter syndrome	+	-	+	-	+/-	Normal or ↓	-	-	Metabolic alkalosis	↑K, ↑Ca, ↑Cl	-	Normal			Mental retardation, Sensorineural hearing loss
	Gitelman syndrome	+	-	+	-	+	Normal	-	-	Metabolic alkalosis	↑K, ↓Ca, ↑Cl	-	Normal			Growth retardation, Tetany, Muscle cramp
	Liddle syndrome	-	-	+/-	-	-	↑	-	+/-	Metabolic alkalosis	↑K, ↓Na	↓PRA, ↓PAC				Pseudohyperaldosteronism
	Diuretic use	+/-	-	+	-	+/-	↓	-	+	Metabolic alkalosis	↑K	↑Na	Normal	Normal	History	-
	Hemodialysis	+/-	+/-	+/-	-	-	Normal	Pustular lesions	-	Metabolic alkalosis	Normal	↓Na	Normal	Normal	History	Carpal tunnel syndrome
	Primary hyperaldosteronism	+	-	+	-	+	↑	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	+	+/-	+/-	-	-	↑	Facial plethora, Purple striae	+	Metabolic alkalosis	Glucosuria	↑BS	Unilateral adrenal hyperplasia	-	Urinary free cortisol (24-hour)	Dorsicocervical fat pad, Obesity, Hirsutism
Gastrointestinal disorders	GI bleeding
	Vomiting
	Severe diarrhea
	Villous adenoma
	VIPoma
Neuropsychiatric disorders	Hypokalemic periodic paralysis
	Central diabetes insipidus
	Bulimia nervosa
	Anorexia nervosa
	Primary polydipsia
Systemic diseases	Hypothermia
	Alcoholism
	Diabetic ketoacidosis
	Hypothermia
	Hypomagnesemia
	Burns
	Cystic fibrosis

References

Template:WH Template:WS

@@ Line 12: / Line 12: @@
 ! colspan="2" rowspan="5" |Diseases
 ! colspan="8" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
-! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
+! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
 ! colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
 ! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
@@ Line 19: / Line 19: @@
 ! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
 |-
-! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
+! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
 ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
 |-
@@ Line 29: / Line 29: @@
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Edema
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |ABG
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
@@ Line 50: / Line 49: @@
 !-
 ![[Metabolic alkalosis]]
-!↓[[Potassium|K]]
 !↑[[Potassium|K]], ↑[[Ca]], ↑[[Chloride|Cl]]
 !-
@@ Line 68: / Line 66: @@
 !-
 ![[Metabolic alkalosis]]
-!↓[[Potassium|K]]
 !↑[[Potassium|K]], ↓[[Ca]], ↑[[Chloride|Cl]]
 !-
@@ Line 86: / Line 83: @@
 !+/-
 ![[Metabolic alkalosis]]
-!↓[[Potassium|K]]
 !↑[[Potassium|K]], ↓[[Sodium|Na]]
 !↓'''[[Plasma renin activity|PRA]]''', ↓'''[[Aldosterone|PAC]]'''
@@ Line 104: / Line 100: @@
 !+
 ![[Metabolic alkalosis]]
-!↓[[Potassium|K]], ↑[[Sodium|Na]]
 !↑[[Potassium|K]]
-!-
+!↑[[Sodium|Na]]
 !Normal
 !Normal
@@ Line 122: / Line 117: @@
 !-
 ![[Metabolic alkalosis]]
-!↓[[Potassium|K]], ↓[[Sodium|Na]]
 !Normal
-!-
+!↓[[Sodium|Na]]
 !Normal
 !Normal
@@ Line 140: / Line 134: @@
 !-
 ![[Metabolic alkalosis]]
-!↓[[Potassium|K]], ↑[[Sodium|Na]]
 !↑[[Potassium|K]], ↓[[Sodium|Na]]
-!↓'''[[Plasma renin activity|PRA]]''', ↑'''[[Aldosterone|PAC]]'''
+!↓'''[[Plasma renin activity|PRA]]''', ↑'''[[Aldosterone|PAC]], ↓[[Sodium|Na]]'''
 !Unilateral [[adrenal hyperplasia]]
 !Hypodense unilateral [[Adrenal Mass|adrenal macroadenoma]] (>1 cm)
@@ Line 149: / Line 142: @@
 |-
 ![[Cushing syndrome]]
-!
+!+
-!
+!+/-
-!
+!+/-
-!
+!-
-!
+!-
-!
+!↑
-!
+![[Plethora|Facial plethora]], [[Striae|Purple striae]]
-!
+!+
-!
+![[Metabolic alkalosis]]
-!
+![[Glucosuria]]
-!
+!↑[[Blood sugar|BS]]
-!
+!Unilateral [[adrenal hyperplasia]]
-!
+!-
-!
+!'''Urinary free [[cortisol]] (24-hour)'''
-!
+!Dorsicocervical [[fat pad]], [[Obesity]], [[Hirsutism]]
-!
 |-
 ! rowspan="5" |[[Gastrointestinal disorders]]
 ![[Gastrointestinal bleeding|GI bleeding]]
-!
 !
 !
@@ Line 186: / Line 177: @@
 |-
 ![[Vomiting]]
-!
 !
 !
@@ Line 204: / Line 194: @@
 |-
 !Severe [[diarrhea]]
-!
 !
 !
@@ Line 222: / Line 211: @@
 |-
 ![[Villous adenoma]]
-!
 !
 !
@@ Line 240: / Line 228: @@
 |-
 ![[VIPoma]]
-!
 !
 !
@@ Line 259: / Line 246: @@
 ! rowspan="5" |[[Neuropsychiatric|Neuropsychiatric disorders]]
 ![[Hypokalemic periodic paralysis]]
-!
 !
 !
@@ Line 277: / Line 263: @@
 |-
 ![[Central diabetes insipidus]]
-!
 !
 !
@@ Line 295: / Line 280: @@
 |-
 ![[Bulimia nervosa]]
-!
 !
 !
@@ Line 313: / Line 297: @@
 |-
 ![[Anorexia nervosa]]
-!
 !
 !
@@ Line 331: / Line 314: @@
 |-
 ![[Polydipsia|Primary polydipsia]]
-!
 !
 !
@@ Line 350: / Line 332: @@
 ! rowspan="7" |[[Systemic diseases]]
 ![[Hypothermia]]
-!
 !
 !
@@ Line 368: / Line 349: @@
 |-
 ![[Alcoholism]]
-!
 !
 !
@@ Line 386: / Line 366: @@
 |-
 ![[Diabetic ketoacidosis]]
-!
 !
 !
@@ Line 404: / Line 383: @@
 |-
 ![[Hypothermia]]
-!
 !
 !
@@ Line 422: / Line 400: @@
 |-
 ![[Hypomagnesemia]]
-!
 !
 !
@@ Line 440: / Line 417: @@
 |-
 ![[Burns]]
-!
 !
 !
@@ Line 458: / Line 434: @@
 |-
 ![[Cystic fibrosis]]
-!
 !
 !

Hypokalemia differential diagnosis: Difference between revisions

Revision as of 20:06, 18 May 2018

Overview

Differentiating Causes of Hypokalemia

Differentiating the diseases that can cause hypokalemia is as following:

References

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