A 3-year old girl with seizures, hypokalemia and metabolic alkalosis
A 3-year-old girl presented to the emergency department with seizures, low-grade fever and vomiting. She had tachycardia and a slow capillary refill. Blood pressure could not be measured. Because of suspected sepsis and/or meningo-encephalitis, broad spectrum antibiotics and antiviral medication wer...
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| Veröffentlicht in: | BMJ case reports 2010-11, Vol.2010 (nov24 1), p.bcr1120092500-bcr1120092500 |
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| creator | Harnisch, E Leertouwer, T Cransberg, K Kist-van Holthe, J E |
| description | A 3-year-old girl presented to the emergency department with seizures, low-grade fever and vomiting. She had tachycardia and a slow capillary refill. Blood pressure could not be measured. Because of suspected sepsis and/or meningo-encephalitis, broad spectrum antibiotics and antiviral medication were given together, along with volume expansion and anticonvulsive therapy. A few hours later, after a second seizure, the blood pressure was extremely high (156/116 mm Hg). The girl was treated with anticonvulsants and intravenous antihypertensive agents. MRI of the brain showed signs of posterior reversible encephalopathy syndrome. Cultures of blood and cerebrospinal fluid remained sterile. Further investigation into the cause of the malignant hypertension revealed hypokalemia, metabolic alkalosis and extremely high plasma renin activity, caused by a rare renal abnormality: bilateral renal segmental hypoplasia or Ask-Upmark kidneys. |
| doi_str_mv | 10.1136/bcr.11.2009.2500 |
| format | Article |
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She had tachycardia and a slow capillary refill. Blood pressure could not be measured. Because of suspected sepsis and/or meningo-encephalitis, broad spectrum antibiotics and antiviral medication were given together, along with volume expansion and anticonvulsive therapy. A few hours later, after a second seizure, the blood pressure was extremely high (156/116 mm Hg). The girl was treated with anticonvulsants and intravenous antihypertensive agents. MRI of the brain showed signs of posterior reversible encephalopathy syndrome. Cultures of blood and cerebrospinal fluid remained sterile. 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She had tachycardia and a slow capillary refill. Blood pressure could not be measured. Because of suspected sepsis and/or meningo-encephalitis, broad spectrum antibiotics and antiviral medication were given together, along with volume expansion and anticonvulsive therapy. A few hours later, after a second seizure, the blood pressure was extremely high (156/116 mm Hg). The girl was treated with anticonvulsants and intravenous antihypertensive agents. MRI of the brain showed signs of posterior reversible encephalopathy syndrome. Cultures of blood and cerebrospinal fluid remained sterile. Further investigation into the cause of the malignant hypertension revealed hypokalemia, metabolic alkalosis and extremely high plasma renin activity, caused by a rare renal abnormality: bilateral renal segmental hypoplasia or Ask-Upmark kidneys.</description><subject>Alkalosis</subject><subject>Alkalosis - diagnosis</subject><subject>Alkalosis - etiology</subject><subject>Antibiotics</subject><subject>Blood pressure</subject><subject>Brain - pathology</subject><subject>Cardiac arrhythmia</subject><subject>Cerebrospinal fluid</subject><subject>Child, Preschool</subject><subject>Creatinine</subject><subject>Diagnostic Errors</subject><subject>Epilepsy, Generalized - diagnosis</subject><subject>Epilepsy, Generalized - etiology</subject><subject>Europe (West)</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Malignant - diagnosis</subject><subject>Hypokalemia</subject><subject>Hypokalemia - diagnosis</subject><subject>Hypokalemia - etiology</subject><subject>Intellectual Disability - diagnosis</subject><subject>Intellectual Disability - etiology</subject><subject>Kidney - abnormalities</subject><subject>Kidneys</subject><subject>Lennox Gastaut Syndrome</subject><subject>Leukocytes</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical imaging</subject><subject>Metabolism</subject><subject>Potassium</subject><subject>Rare Disease</subject><subject>Renal Artery - abnormalities</subject><subject>Spasms, Infantile - diagnosis</subject><subject>Spasms, Infantile - etiology</subject><subject>Urogenital system</subject><subject>Veins & arteries</subject><subject>White</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkc1r3DAQxUVpaEKSe09FkEuh9Wb0YUu6FELafECglxR6E7I9m9VWtjbSOmXz11fLpiHppXOZh_SbxwyPkPcMZoyJ5rTtUhEzDmBmvAZ4Qw6YqlWlDPx8-0Lvk-Ocl1BKMKmleEf2OVdGSc0PyNczKqoNukRj6OmdT4H-9usFzegfp4T5M11sVvGXCzh4R93Y0wHXro3Bd9SF8h6zz0dkb-5CxuOnfkh-XHy7Pb-qbr5fXp-f3VStlDVUEhnW4EAqoxlrJAowghlV97VA7rgWc6FVY5pet8Cl4dgJBa4RCNiZrhWH5MvOdzW1A_Ydjuvkgl0lP7i0sdF5-_pn9At7Fx-sAK60kMXg45NBivcT5rUdfO4wBDdinLJlwJtGG6h1QU_-QZdxSmM5zzKludGCC1Eo2FFdijknnD8vw8BuU7IlpSLsNiW7TamMfHh5xPPA30wK8GkHtMPy_3Z_AHvHmTc</recordid><startdate>20101126</startdate><enddate>20101126</enddate><creator>Harnisch, E</creator><creator>Leertouwer, T</creator><creator>Cransberg, K</creator><creator>Kist-van Holthe, J E</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20101126</creationdate><title>A 3-year old girl with seizures, hypokalemia and metabolic alkalosis</title><author>Harnisch, E ; Leertouwer, T ; Cransberg, K ; Kist-van Holthe, J E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b4450-4e1e50a047981164e30931975d53e2a283f387696d8b02492ec370a63e0ec9cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Alkalosis</topic><topic>Alkalosis - diagnosis</topic><topic>Alkalosis - etiology</topic><topic>Antibiotics</topic><topic>Blood pressure</topic><topic>Brain - pathology</topic><topic>Cardiac arrhythmia</topic><topic>Cerebrospinal fluid</topic><topic>Child, Preschool</topic><topic>Creatinine</topic><topic>Diagnostic Errors</topic><topic>Epilepsy, Generalized - diagnosis</topic><topic>Epilepsy, Generalized - etiology</topic><topic>Europe (West)</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Malignant - diagnosis</topic><topic>Hypokalemia</topic><topic>Hypokalemia - diagnosis</topic><topic>Hypokalemia - etiology</topic><topic>Intellectual Disability - diagnosis</topic><topic>Intellectual Disability - etiology</topic><topic>Kidney - abnormalities</topic><topic>Kidneys</topic><topic>Lennox Gastaut Syndrome</topic><topic>Leukocytes</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical imaging</topic><topic>Metabolism</topic><topic>Potassium</topic><topic>Rare Disease</topic><topic>Renal Artery - abnormalities</topic><topic>Spasms, Infantile - diagnosis</topic><topic>Spasms, Infantile - etiology</topic><topic>Urogenital system</topic><topic>Veins & arteries</topic><topic>White</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harnisch, E</creatorcontrib><creatorcontrib>Leertouwer, T</creatorcontrib><creatorcontrib>Cransberg, K</creatorcontrib><creatorcontrib>Kist-van Holthe, J E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harnisch, E</au><au>Leertouwer, T</au><au>Cransberg, K</au><au>Kist-van Holthe, J E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A 3-year old girl with seizures, hypokalemia and metabolic alkalosis</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2010-11-26</date><risdate>2010</risdate><volume>2010</volume><issue>nov24 1</issue><spage>bcr1120092500</spage><epage>bcr1120092500</epage><pages>bcr1120092500-bcr1120092500</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>A 3-year-old girl presented to the emergency department with seizures, low-grade fever and vomiting. She had tachycardia and a slow capillary refill. Blood pressure could not be measured. Because of suspected sepsis and/or meningo-encephalitis, broad spectrum antibiotics and antiviral medication were given together, along with volume expansion and anticonvulsive therapy. A few hours later, after a second seizure, the blood pressure was extremely high (156/116 mm Hg). The girl was treated with anticonvulsants and intravenous antihypertensive agents. MRI of the brain showed signs of posterior reversible encephalopathy syndrome. Cultures of blood and cerebrospinal fluid remained sterile. Further investigation into the cause of the malignant hypertension revealed hypokalemia, metabolic alkalosis and extremely high plasma renin activity, caused by a rare renal abnormality: bilateral renal segmental hypoplasia or Ask-Upmark kidneys.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>22797482</pmid><doi>10.1136/bcr.11.2009.2500</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Alkalosis Alkalosis - diagnosis Alkalosis - etiology Antibiotics Blood pressure Brain - pathology Cardiac arrhythmia Cerebrospinal fluid Child, Preschool Creatinine Diagnostic Errors Epilepsy, Generalized - diagnosis Epilepsy, Generalized - etiology Europe (West) Female Humans Hypertension Hypertension, Malignant - diagnosis Hypokalemia Hypokalemia - diagnosis Hypokalemia - etiology Intellectual Disability - diagnosis Intellectual Disability - etiology Kidney - abnormalities Kidneys Lennox Gastaut Syndrome Leukocytes Magnetic Resonance Imaging Medical imaging Metabolism Potassium Rare Disease Renal Artery - abnormalities Spasms, Infantile - diagnosis Spasms, Infantile - etiology Urogenital system Veins & arteries White |
| title | A 3-year old girl with seizures, hypokalemia and metabolic alkalosis |
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