Dysarthria in a patient with probable acquired chloridorrhea.
The authors encountered a patient who had profound hypochloremic metabolic alkalosis after developing profuse diarrhea related to rejection of her small bowel transplant. Her ileostomy fluid showed massive electrolyte losses and was exceptionally high in chloride content. She improved with volume substitution and a proton pump inhibitor, although she subsequently required repeat small bowel transplant. The authors speculate that an impaired "downregulated in adenoma" gene (DRA) that enclodes an apical Cl(-)/HO(-)(HCO(3)) exchanger may have contributed to an acquired chloridorrhea in this patient.
Marx
Manfred
M
Center for Dialysis and Nephrology, Südharz Hospital, Nordhausen, Germany.
Marx
Christian
C
Luft
Friedrich C
FC
D000328:Adult; D000471:Alkalosis / Q000209:etiology; D017920:Antiporters; D001639:Bicarbonates / Q000378:metabolism; D002352:Carrier Proteins / Q000502:physiology; D027963:Chloride-Bicarbonate Antiporters; D002712:Chlorides / Q000378:metabolism*; D003244:Consciousness Disorders / Q000209:etiology*; D003424:Crohn Disease / Q000601:surgery; D003967:Diarrhea / Q000150:complications*; D004401:Dysarthria / Q000209:etiology*; D005243:Feces / Q000737:chemistry; D005260:Female; D006084:Graft Rejection / Q000150:complications*; D006801:Humans; D007081:Ileostomy; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology; D007421:Intestine, Small / Q000637:transplantation*; D008565:Membrane Proteins / Q000502:physiology; D010288:Parenteral Nutrition; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D012778:Short Bowel Syndrome / Q000601:surgery; D000076988:Sulfate Transporters
D017920:Antiporters; D001639:Bicarbonates; D002352:Carrier Proteins; D027963:Chloride-Bicarbonate Antiporters; D002712:Chlorides; D008565:Membrane Proteins; C081011:SLC26A3 protein, human; D000076988:Sulfate Transporters