Hypokalaemic metabolic alkalosis, hypertension and diabetes: what is the link
| Autor: | Niklaus Kamber, Marius Vögelin, Richard Cathomas, Thomas Fehr |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class medicine.medical_treatment Metabolic alkalosis Hypokalemia 030209 endocrinology & metabolism Adrenocorticotropic hormone 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans 030212 general & internal medicine Cushing Syndrome Chemotherapy Metyrapone business.industry Alkalosis General Medicine Middle Aged medicine.disease Reminder of Important Clinical Lesson Treatment Outcome Endocrinology Mineralocorticoid Hypertension Radionuclide therapy Steroid 11-beta-Hydroxylase Female business Glucocorticoid medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | Two years after diagnosis of a metastatic neuroendocrine gastrin-secreting tumour and after several cycles of chemotherapy and peptide receptor radionuclide therapy, a 56-year-old woman presented with hypokalaemic metabolic alkalosis, hypertension, leg oedema and new-onset diabetes mellitus. Further investigations revealed renal potassium loss confirmed by a transtubular potassium gradient of 16, fully suppressed serum aldosterone, but instead highly elevated blood levels of morning cortisol and adrenocorticotropic hormone as well as increased urinary excretion of glucocorticoid and mineralocorticoid metabolites. Ruling out other causes, paraneoplastic hypercortisolism was diagnosed. Pharmacological inhibition of the steroid 11β-hydroxylase with metyrapone resulted in complete resolution of metabolic alkalosis, hypokalaemia, hypertension, hyperglycaemia and leg oedema within 1 week. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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