title: Over-expression of colonic K+ channels associated with severe potassium secretory diarrhoea after haemorrhagic shock.
abstract: A 67-year-old woman with end-stage renal disease (ESRD) was referred with chronic diarrhoea, severe hypokalaemia and recurrent colonic pseudo-obstructions following haemorrhagic shock. The cause of secretory diarrhoea was uncertain, but an ileostomy identified the colon as the source of the watery diarrhoea and potassium (K(+)) losses, and symptoms only resolved after colectomy. Immunohistochemistry of the colon revealed over-expression of high conductance K(+) (BK) channel protein in surface colonocytes and crypt cells compared with controls and other patients with ESRD. We hypothesize that colonic ischaemia during haemorrhagic shock led to increased BK channel expression and thus enhanced colonic K(+) and water secretion, resulting in severe hypokalaemia and colonic pseudo-obstruction.
authors.affiliation: Gastroenterology Unit, European Hospital G. Pompidou, APHP, Paris, France. marion.simon3@free.fr
authors.forename: Marion
authors.initials: M
authors.lastname: Simon
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Duong
authors.forename: Vincent
authors.initials: V
authors.lastname: Mallet
authors.forename: Raymond
authors.initials: R
authors.lastname: Jian
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: MacLennan
authors.forename: Geoffrey I
authors.initials: GI
authors.lastname: Sandle
authors.forename: Philippe
authors.initials: P
authors.lastname: Marteau
mesh_terms: D000368:Aged; D003106:Colon / Q000098:blood supply / Q000473:pathology; D003967:Diarrhea / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000209:etiology / Q000378:metabolism; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D007511:Ischemia / Q000209:etiology / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications; D051036:Large-Conductance Calcium-Activated Potassium Channels / Q000378:metabolism*; D011188:Potassium / Q000378:metabolism*; D012771:Shock, Hemorrhagic / Q000150:complications*
chemical_list: D051036:Large-Conductance Calcium-Activated Potassium Channels; D011188:Potassium