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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Overview
Dehydration synthesis (also called a condensation reaction) is the chemical process in which two molecules covalently link together to form a new molecule, along with the release of a water molecule. Many physiologically important compounds form by dehydration synthesis reactions, such as complex carbohydrates, proteins, DNA, and RNA.
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Dehydrated patient without clinically evident cause: A case report.

Federica Palladino1, Maria Cristina Fedele1, Marianna Casertano1

  • 1Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples 80138, Italy.

World Journal of Clinical Cases
|November 16, 2020
PubMed
Summary

Cystic fibrosis can mimic Bartter's syndrome, causing hypokalemic metabolic alkalosis. Consider cystic fibrosis in differential diagnoses, even with negative newborn screening, especially in hot conditions.

Keywords:
Case reportChildrenCystic fibrosisDehydrationHeat exposureMetabolic alkalosisPseudo-Bartter syndrome

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Area of Science:

  • Pediatric Endocrinology
  • Medical Genetics

Background:

  • Cystic fibrosis (CF) can manifest with metabolic alkalosis, mimicking Bartter's syndrome.
  • This case report highlights CF as a differential diagnosis for metabolic alkalosis, particularly when newborn screening is negative.

Observation:

  • An 8-month-old female presented with severe dehydration and hypokalemic metabolic alkalosis during high environmental temperatures (36°C).
  • Symptoms occurred without fever, diarrhea, or vomiting, prompting a differential diagnosis between CF and tubulopathies like Bartter's Syndrome.

Findings:

  • The patient was diagnosed with mild cystic fibrosis, confirmed by heterozygous mutations (G126D and F508del) in the CFTR gene.
  • Heat exposure was identified as the trigger for this presentation.

Implications:

  • Hypokalemic metabolic alkalosis in pediatric patients warrants consideration of cystic fibrosis presenting as Pseudo-Bartter's syndrome.
  • This diagnosis is crucial even if initial newborn screening for CF was negative.