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Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)

We report a case of hypokalemia resulting from colonic pseudo-obstruction or Ogilvie's syndrome. Colonic pseudo-obstruction is characterized by profuse watery diarrhea that has a low sodium and high potassium concentration. It is seen in a variety of medical and surgical conditions, but its exa...

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Autores principales: Sunnoqrot, Naseem, Reilly, Robert F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478324/
https://www.ncbi.nlm.nih.gov/pubmed/26120577
http://dx.doi.org/10.1159/000431086
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author Sunnoqrot, Naseem
Reilly, Robert F.
author_facet Sunnoqrot, Naseem
Reilly, Robert F.
author_sort Sunnoqrot, Naseem
collection PubMed
description We report a case of hypokalemia resulting from colonic pseudo-obstruction or Ogilvie's syndrome. Colonic pseudo-obstruction is characterized by profuse watery diarrhea that has a low sodium and high potassium concentration. It is seen in a variety of medical and surgical conditions, but its exact cause remains unknown. It is thought to result from an imbalance of sympathetic and parasympathetic input in the distal colon. The diarrhea is secretory and driven by potassium secretion rather than the inhibition of sodium reabsorption or chloride secretion, which are the most common pathophysiologic mechanisms of secretory diarrhea. Affected patients often lose >100 mmol of potassium daily. Colonic pseudo-obstruction is associated with a dramatic upregulation of the maxiK or BK potassium channel. This channel plays a prominent role in flow-mediated potassium secretion in the connecting tubule and collecting duct and is also upregulated in the distal colon in patients with advanced chronic kidney disease and end-stage renal disease. In vitro studies show that the channel is regulated by catecholamine binding to the β receptor and cyclic AMP upregulation, somatostatin and aldosterone, insights that can be used to help guide pharmacologic therapy. Nephrologists should be aware of colonic pseudo-obstruction as a cause of extrarenal potassium loss.
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spelling pubmed-44783242015-06-26 Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome) Sunnoqrot, Naseem Reilly, Robert F. Case Rep Nephrol Dial Published online: May, 2015 We report a case of hypokalemia resulting from colonic pseudo-obstruction or Ogilvie's syndrome. Colonic pseudo-obstruction is characterized by profuse watery diarrhea that has a low sodium and high potassium concentration. It is seen in a variety of medical and surgical conditions, but its exact cause remains unknown. It is thought to result from an imbalance of sympathetic and parasympathetic input in the distal colon. The diarrhea is secretory and driven by potassium secretion rather than the inhibition of sodium reabsorption or chloride secretion, which are the most common pathophysiologic mechanisms of secretory diarrhea. Affected patients often lose >100 mmol of potassium daily. Colonic pseudo-obstruction is associated with a dramatic upregulation of the maxiK or BK potassium channel. This channel plays a prominent role in flow-mediated potassium secretion in the connecting tubule and collecting duct and is also upregulated in the distal colon in patients with advanced chronic kidney disease and end-stage renal disease. In vitro studies show that the channel is regulated by catecholamine binding to the β receptor and cyclic AMP upregulation, somatostatin and aldosterone, insights that can be used to help guide pharmacologic therapy. Nephrologists should be aware of colonic pseudo-obstruction as a cause of extrarenal potassium loss. S. Karger AG 2015-05-28 /pmc/articles/PMC4478324/ /pubmed/26120577 http://dx.doi.org/10.1159/000431086 Text en Copyright © 2015 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
spellingShingle Published online: May, 2015
Sunnoqrot, Naseem
Reilly, Robert F.
Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)
title Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)
title_full Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)
title_fullStr Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)
title_full_unstemmed Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)
title_short Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)
title_sort hypokalemia associated with colonic pseudo-obstruction (ogilvie's syndrome)
topic Published online: May, 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478324/
https://www.ncbi.nlm.nih.gov/pubmed/26120577
http://dx.doi.org/10.1159/000431086
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