Alcalosis metabólica de origen dietético en un lactante

Medina, Orlando Mesa; González, J. León; Nieto, V. García; Ramírez, S. Romero; Perez, CY

doi:10.1016/j.anpedi.2008.11.026

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…Nine further cases were observed in non-breastfed infants (six boys and three girls) aged from 4 weeks to 14 months (with a median age of 6 months). After excluding the causes of chloride deficiency discussed for the five aforementioned breastfed infants, the possible diagnosis of dietary chloride deficiency was suspected [23][24][25][26][27][28][29]. Meticulous history-taking revealed that the children were on unconventional formulas: hypoallergenic formulas (N = 3), almond milk (N = 3), rice milk (N = 2), and homemade blended formula (N = 1).…”

Section: Dietary Chloride Depletion Alkalosis After the Initial (1979mentioning

confidence: 99%

Dietary Chloride Deficiency Syndrome: Pathophysiology, History, and Systematic Literature Review

et al. 2020

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Metabolic alkalosis may develop as a consequence of urinary chloride (and sodium) wasting, excessive loss of salt in the sweat, or intestinal chloride wasting, among other causes. There is also a likely underrecognized association between poor salt intake and the mentioned electrolyte and acid–base abnormality. In patients with excessive loss of salt in the sweat or poor salt intake, the maintenance of metabolic alkalosis is crucially modulated by the chloride–bicarbonate exchanger pendrin located on the renal tubular membrane of type B intercalated cells. In the late 1970s, recommendations were made to decrease the salt content of foods as part of an effort to minimize the tendency towards systemic hypertension. Hence, the baby food industry decided to remove added salt from formula milk. Some weeks later, approximately 200 infants (fed exclusively with formula milks with a chloride content of only 2–4 mmol/L), were admitted with failure to thrive, constipation, food refusal, muscular weakness, and delayed psychomotor development. The laboratory work-up disclosed metabolic alkalosis, hypokalemia, hypochloremia, and a reduced urinary chloride excretion. In all cases, both the clinical and the laboratory features remitted in ≤7 days when the infants were fed on formula milk with a normal chloride content. Since 1982, 13 further publications reported additional cases of dietary chloride depletion. It is therefore concluded that the dietary intake of chloride, which was previously considered a “mendicant” ion, plays a crucial role in acid–base and salt balance.

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Section: Dietary Chloride Depletion Alkalosis After the Initial (1979mentioning

confidence: 99%

Dietary Chloride Deficiency Syndrome: Pathophysiology, History, and Systematic Literature Review

et al. 2020

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“…La deshidratación es usualmente leve y se pueden encontrar anorexia, apatía, irritabilidad, fiebre, deshidratación, pérdida de peso y retardo en el crecimiento. Puede haber antecedentes de episodios similares y de síntomas digestivos o respiratorios y, en las formas más crónicas, a menudo hay retardo del crecimiento (1, 10,13,16,[19][20][21].…”

Section: Fibrosis Quísticaunclassified

Alcalosis metabólica hipoclorémica como presentación de la fibrosis quística. Informe de dos casos

Múnera

Valencia

Flórez

et al. 2013

Iatreia

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Introducción: se describen los casos de dos pacientes con fibrosis quística (FQ) con alcalosis metabólica hipoclorémica: uno con diagnóstico de novo y otro con una recaída. Casos clínicos: pacientes de 6 y 9 meses que consultan por tos, fiebre y disnea. El primero con síndrome bronco-obstructivo recurrente (SBOR), el segundo con FQ conocida. Examen físico: dificultad respiratoria, deshidratación y desnutrición. Gasometría: alcalosis metabólica, hipokalemia e hipocloremia graves. Se tratan con cloruro de sodio y potasio. Hay mejoría del desequilibrio electrolítico y del estado ácido-base. No se documentan pérdidas renales o gastrointestinales de cloro y se diagnostica síndrome pseudo-Bartter. Los electrólitos en sudor de ambos pacientes son elevados. Se diagnostica alcalosis metabólica por FQ. Conclusión: la alcalosis metabólica puede ser la manifestación inicial en niños con SBOR y talla baja con sospecha de FQ; igualmente puede hacer parte de una exacerbación aguda en pacientes conocidos con FQ. Con su reconocimiento y tratamiento oportunos disminuye la morbilidad.

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Complications carentielles suite à l’utilisation de « laits » végétaux, chez des nourrissons de deux mois et demi à 14 mois (quatre cas)

et al. 2013

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Alcalosis metabólica de origen dietético en un lactante

Cited by 5 publications

References 9 publications

Dietary Chloride Deficiency Syndrome: Pathophysiology, History, and Systematic Literature Review

Dietary Chloride Deficiency Syndrome: Pathophysiology, History, and Systematic Literature Review

Alcalosis metabólica hipoclorémica como presentación de la fibrosis quística. Informe de dos casos

Complications carentielles suite à l’utilisation de « laits » végétaux, chez des nourrissons de deux mois et demi à 14 mois (quatre cas)

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