Severe hypokalemia in a child with mild gastroenteritis

• Autor(a) principal: Faria, Catarina
• Data de Publicação: 2019
• Outros Autores: Ferreira, Carina, Sarmento, Alzira, Gonçalves, Sara, Rocha, Paula, Duarte, Carlos, Mota, Conceição
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25753/BirthGrowthMJ.v28.i3.15338
• topic: Case Reports

Background: Hypokalemia (serum potassium below 3.5 mmol/L) may be caused by several mechanisms. Severe hypokalemia must be immediately managed, as it can have important cardiac repercussions. Clinical case: A previously healthy eight-year-old female, with normal growth and normal-to-low blood pressure, was observed due to persistent abdominal pain, anorexia, and fever two days after overcoming a mild gastroenteritis episode. Serum biochemistry revealed severe hypokalemia (1.8 mmol/L), hypomagnesemia, and metabolic alkalosis. The patient was admitted to the Pediatric Intensive Care Unit for correction of electrolyte imbalance, cardiac monitoring, and investigation. Complementary studies included a spot urine ionogram that revealed inappropriate potassium wasting. Ionic correction was achieved by both intravenous and oral supplementation plus spironolactone. Genetic testing was positive for Gitelman syndrome. Discussion/Conclusion: Suspicion of complex causes should be raised and a comprehensive approach undertaken upon a discrepancy between clinical history and hypokalemia severity.