ABSTRACT
The clinical features of 16 males and 2 females with hypokalemic periodic paralysis (HPP) are presented. Five patients had familial HPP, 4 thyrotoxic HPP and 9 sporadic disease. The age of onset ranged from 6 to 42 years. Clinical pictures varied from paraparesis to severe quadriplegia. The disease onset was earlier in familial HPP (p < 0.05) while sporadic cases showed the most severe, albeit shorter paralysis (p < 0.05). On admission, serum potassium levels ranged from 1.5 to 3.3 mEq/L; they did not correlate with the severity of paralysis. Glucose-insulin provocation test was positive in 5/5 patients. Oral potassium chloride and amiloride were useful to prevent paralysis. Contrasting with reports from USA and Europe, in México, HPP is not exceptional, and should be considered in the differential diagnosis of acute paralysis.
Subject(s)
Paralyses, Familial Periodic/diagnosis , Adolescent , Adult , Child , Diagnosis, Differential , Female , Humans , Male , Mexico , Paralyses, Familial Periodic/blood , Pedigree , Potassium/bloodABSTRACT
We report the results of an oral tolerance test performed in 317 patients with kidney stones. In order to avoid PTH or AMPc measurements, and therefore to reduce costs and time to get the results, we measured the tubular maxima of phosphate per glomerular filtration rate (TmP04/GFR, the phosphate threshold). Urine collections from 7 to 9 h and from 9 to 13 h were obtained. The samples were analyzed for calcium, creatinine and phosphorus content. All patients ingested 1 g of calcium mixed in a meal at 9 o'clock. Venous blood samples were obtained for calcium, creatinine and phosphorus measurements, previous to the calcium ingestion. Urinary calcium to creatinine ratio, before and after the calcium-load, as well as TmP04/GFR were calculated. In 97 subjects (30.8%) there were no calcium metabolism abnormalities. Idiopathic hypercalciuria was present in 183 (57%) and primary hyperparathyroidism in 37 (11.7%). Idiopathic hypercalciuria was classified in four subgroups: absorptive hypercalciuria with normal serum phosphorus, absorptive hypercalciuria with low serum phosphorus (renal phosphate leak), renal hypercalciuria with normal phosphorus and renal hypercalciuria with low serum phosphorus.
