scholarly journals Hyperemesis Gravidarum Presenting as Severe Hypokalemic Periodic Paralysis and Type II Respiratory Failure: A Different Form of Thyroid Storm?

Cureus ◽  
2021 ◽  
Author(s):  
Srinivas Naik ◽  
Dhruv Talwar ◽  
Sourya Acharya ◽  
Sunil Kumar ◽  
Deepti Shrivastava
Keyword(s):  
Respiratory Failure ◽  
Hyperemesis Gravidarum ◽  
Periodic Paralysis ◽  
Thyroid Storm ◽  
Type Ii ◽  
Hypokalemic Periodic Paralysis

scholarly journals Tata laksana Pasien Gravida 29–30 Minggu dengan Gagal Napas ec. Hypokalemic Periodic Paralysis yang Diperberat dengan Community Acquired Pneumonia

2019 ◽  
Vol 7 (2) ◽  
pp. 124-133
Author(s):  
Mariko Gunadi ◽  
Suwarman Suwarman ◽  
Nurita Dian Kestriani S
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Pregnant Patient ◽  
Periodic Paralysis ◽  
Community Acquired Pneumonia ◽  
Hypokalemic Periodic Paralysis

Penatalaksanaan sakit kritis pada wanita hamil memiliki karakteristik yang unik karena  perubahan fisiologi selama kehamilan dan janin yang berkembang dalam uterus yang mendapat implikasi yang signifikan. Pada kasus ini, seorang perempuan 27 tahun yang sedang hamil gemeli usia kehamilan 29–30 minggu datang ke Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung dengan keluhan utama kelemahan keempat anggota gerak. Hasil pemeriksaan laboratorium didapatkan kadar kalium sangat rendah dan didiagnosis dengan hypokalemic periodic paralysis. Pasien mengalami gagal napas  sehingga dilakukan intubasi dan diberikan bantuan ventilasi mekanik, kemudian dirawat di Intensive Care Unit (ICU). Gagal napas disertai penyulit community acquired pneumonia. Tata laksana ventilasi mekanik pada wanita hamil di ICU bersifat suportif dengan teknik sama seperti pada pasien tidak hamil, namun memiliki target khusus yang berbeda. Monitoring fetal heart rate (FHR) dapat mencerminkan kesejahteraan janin dan kondisi ibu. Tujuan penulisan laporan kasus ini adalah mengetahui pentingnya target pemberian ventilasi mekanik dan melakukan monitoring FHR pada pasien hamil di ICU. Management of Respiratory Failure Due to Hypokalemic Periodic Paralysis Complicated with Community Acquired Pneumonia in 29–30 Weeks of GestationManagement of critically ill pregnant women in Intensive Care Unit (ICU) has unique characteristics due to the physiological changes during pregnancy and the presence of growing fetus in the uterine which may present significant implications. This study presented a case of a 27 years old woman with 29–30 weeks of gestation of twin pregnancy who came to Emergency Room (ER) with the chief complaint of weakness in both lower and upper extremities. Laboratory investigations showed a very low potassium level and the patient was diagnosed with hypokalemic periodic paralysis. Patient then experienced respiratory failure at the ER, intubated, and mechanically ventilated and was sent to the ICU. Community-acquired pneumonia was complicating the respiratory failure. Basically, mechanical ventilation management for pregnant patient in ICU is supportive in nature and uses the same techniques employed for the non-pregnant patient. However, the goals are different as it is important to monitor fetal heart rate (FHR) in pregnant woman as this does not only reflect the fetal well-being but also the maternal condition. This case report is intended to show the importance of mechanical ventilation goal and FHR monitoring in pregnant patients in ICU.

Morphologic alteration in the muscles of patients with hypokalemic periodic paralysis or myopathy

1990 ◽  
Vol 48 (3) ◽  
pp. 222-223
Author(s):  
T. Shimizu ◽  
Y. Muranaka ◽  
I. Ohta ◽  
N. Honda
Keyword(s):  
Clinical Manifestations ◽  
Quadriceps Muscle ◽  
Honeycomb Structure ◽  
Periodic Paralysis ◽  
Ultrastructural Changes ◽  
Hypokalemic Periodic Paralysis ◽  
Electron Microscopic ◽  
Tubular Aggregates ◽  
Hypokalemic Myopathy ◽  
Transmission Electron

There have been many reports on ultrastructural alterations in muscles of hypokalemic periodic paralysis (hpp) and hypokalemic myopathy(hm). It is stressed in those reports that tubular structures such as tubular aggregates are usually to be found in hpp as a characteristic feature, but not in hm. We analyzed the histological differences between hpp and hm, comparing their clinical manifestations and morphologic changes in muscles. Materials analyzed were biopsied muscles from 18 patients which showed muscular symptoms due to hypokalemia. The muscle specimens were obtained by means of biopsy from quadriceps muscle and fixed with 2% glutaraldehyde (pH 7.4) and analyzed by ordinary method and modified Golgimethod. The ultrathin section were examined in JEOL 200CX transmission electron microscopy.Electron microscopic examinations disclosed dilated t-system and terminal cistern of sarcoplasmic reticulum (SR)(Fig 1), and an unique structure like “sixad” was occasionally observed in some specimens (Fig 2). Tubular aggregates (Fig 3) and honeycomb structure (Fig 4) were also common characteristic structures in all cases. These ultrastructural changes were common in both the hypokalemic periodic paralysis and the hypokalemic myopathy, regardless of the time of biopsy or the duration of hypokalemia suffered.

ANAESTHESIA MANAGEMENT FOR A PATIENT WITH FAMILIAL HYPOKALEMIC PERIODIC PARALYSİS

2014 ◽  
Author(s):  
Özgül Keskin ◽  
Hatice Türe ◽  
Özge Köner ◽  
Ferdi Menda ◽  
Bora Aykaç
Keyword(s):  
Periodic Paralysis ◽  
Hypokalemic Periodic Paralysis

scholarly journals Respiratory Failure Due to Differentiation Arrest and Expansion of Alveolar Cells following Lung-Specific Loss of the Transcription Factor C/EBPα in Mice

2006 ◽  
Vol 26 (3) ◽  
pp. 1109-1123 ◽  
Author(s):  
Daniela S. Bassères ◽  
Elena Levantini ◽  
Hongbin Ji ◽  
Stefano Monti ◽  
Shannon Elf ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Cell Differentiation ◽  
Respiratory Failure ◽  
Leucine Zipper ◽  
Type I ◽  
Type Ii ◽  
Alveolar Cells ◽  
Proliferating Cells ◽  
Therapeutic Benefits ◽  
Factor C

ABSTRACT The leucine zipper family transcription factor CCAAT enhancer binding protein alpha (C/EBPα) inhibits proliferation and promotes differentiation in various cell types. In this study, we show, using a lung-specific conditional mouse model of C/EBPα deletion, that loss of C/EBPα in the respiratory epithelium leads to respiratory failure at birth due to an arrest in the type II alveolar cell differentiation program. This differentiation arrest results in the lack of type I alveolar cells and differentiated surfactant-secreting type II alveolar cells. In addition to showing a block in type II cell differentiation, the neonatal lungs display increased numbers of proliferating cells and decreased numbers of apoptotic cells, leading to epithelial expansion and loss of airspace. Consistent with the phenotype observed, genes associated with alveolar maturation, survival, and proliferation were differentially expressed. Taken together, these results identify C/EBPα as a master regulator of airway epithelial maturation and suggest that the loss of C/EBPα could also be an important event in the multistep process of lung tumorigenesis. Furthermore, this study indicates that exploring the C/EBPα pathway might have therapeutic benefits for patients with respiratory distress syndromes.

Hypokalemic periodic paralysis mutations: Confirmation of mutation and analysis of founder effect

1996 ◽  
Vol 6 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Christie L.S. Grosson ◽  
Jesus Esteban ◽  
Diane McKenna-Yasek ◽  
James F. Gusella ◽  
Robert H. Brown
Keyword(s):  
Founder Effect ◽  
Periodic Paralysis ◽  
Hypokalemic Periodic Paralysis
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