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Severe Hyperkalemia in a Child with Vomiting and Diarrhea
1Sidra Medicine, Department of Emergency Medicine, Ar-Rayyan, Qatar.
Clinical Practice and Cases in Emergency Medicine
|December 20, 2024
Summary
Severe hyperkalemia in a child with congenital adrenal insufficiency caused dangerous ECG changes. Prompt treatment with calcium gluconate rapidly resolved these critical cardiac effects.
Area of Science:
- Pediatrics
- Cardiology
- Endocrinology
Background:
- Congenital adrenal insufficiency (CAH) can predispose children to life-threatening electrolyte imbalances.
- Hyperkalemia, a serious complication, requires prompt recognition and management.
Purpose of the Study:
- To report a case of severe hyperkalemia in an infant with CAH.
- To highlight the characteristic electrocardiogram (ECG) findings and effective treatment strategies.
Main Methods:
- A 13-month-old infant with CAH presented with vomiting and diarrhea.
- ECG revealed ECG changes indicative of severe hyperkalemia (potassium 10.7 mmol/L).
- Treatment included calcium gluconate, insulin, dextrose, and sodium polystyrene sulfonate.
Main Results:
- Intravenous calcium gluconate immediately reversed ECG abnormalities.
- Subsequent medical management normalized serum potassium levels.
- The patient experienced a full recovery.
Conclusions:
- Hyperkalemia poses a significant risk in children with CAH, manifesting with distinct ECG changes.
- Calcium gluconate is crucial for immediate cardioprotection in pediatric hyperkalemia.
- Early recognition of ECG changes associated with hyperkalemia is vital for timely intervention.
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