Akut hipokalemik paralizi ve hipofosfatemi ile başvuran Crohn olgu sunumu

Öz

Elliüç yaşında erkek hasta kaslarda güçsüzlük ve hipokalemik paralizi ile acil servise başvurdu. Hastanın başvuru esnasında hiçbir gastrointestinal semptomu olmamasına rağmen, yapılan araştırmalar sonucunda Crohn hastalığı tanısı aldı. Bu olgu bildiğimiz kadarı ile gastrointestinal semptomu olmadan hipokalemik paralizi tanısı alan literatürdeki ilk olgudur. Crohn hastalığı nutrisyonel eksiklikler ve metabolik hastalık ile başvuran hastaların ayırıcı tanısında düşünülmelidir.

Anahtar Kelimeler

• Crohn hastalığı,hipokalemi,paralizi

A Crohn’s patient presenting with acute hypokalemic paralysis with hypophosphatemia: Case report

Öz

53 years old man admitted to the emergency service with the history of muscle weakness and hypokalemic paralysis. Although the patient had no gastrointestinal symptoms at presentation, he investigated for the underlying cause and he diagnosed Crohn’s disease. As far as we know this is the first case with hypokalemic paralysis caused by Crohn’s disease, without gastrointestinal symptoms in the literature. Crohn’s disease should be considered in the differential diagnosis for patients presenting with nutrient deficiencies or metabolic disease.

Anahtar Kelimeler

• ohn’s disease,hypokalemia,paralysis

Kaynakça

1. 1. Sushil K Ahlawat, Anita Sachdev, Postgrad Med J 1999;75:193-197.
2. 2. Musselman BC, Wenzl JE, Groover RV. Potassium-depletion paralysis: associated with gluten-induced enteropathy. Am J Dis Child 1968; 116 :414-7.
3. 3. Ghosh D,Dhiman RK, Kohli A e t al. Hypokalemic periodic paralysis in association with tropical sprue: a case report. Acta Neurol Scand 1994; 90: 371-3.
4. 4. Manary MJ, Keating JP, Hirshberg GE. Quadriparesis due to potassium depletion. Crit Care Med 1986; 14: 750
5. 5. Orman RA, Lewis JB Jr. Flaccid quadriparesis associated with Yersinia enterocolitis-induced hypokalemia. Arch Intern Med 1989; 149:1193-4.2
6. 6. Hutchinson R,Tyrrell PN, Kumar D, Dunn JA, Li JK, Allan RN, Pathogenesis of gall Stone in Crohn’s disease, an alternative explanation. Gut 1994 Jan;35(1):94-7
7. 7. N.H.Dyer, A.M.Dawson Malnutrition and malabsorption in crohn’s disease with reference to the effect of surgery British Journal of Surgery Society 1973;60:134-140
8. 8. Sambit Sen, Kinesh P. Patel, Aseel M.N. Fattah, Simon M. Greenfield. Crohn ’ s Disease Presenting as Acute Hypokalemic Paralysis, Am J Gastroenterol doi:10.1038/ajg.2009.374

9. 9. Krok KL & Lichtenstein GR (2003) Nutrition in Crohn disease. Curr Opin Gastroenterol 19, 148–153.
10. 10. Ballesteros P, Vidal Casariego A, Calleja Fernandéz A, López Gómez JJ, Urioste Fondo A, Cano Rodríguez I. Impact of nutritional treatment in the evolution of inflammatory bowel disease. Nutr Hosp 2010; 25 (2):181-192.
11. 11. T. Davanço et al. Nutritional supplementation assessment with whey proteins and TGF-βin patients with Crohn’s disease Nutr Hosp. 2012;27(4):1286-1292.
12. 12. Gassull MA & Cabre E (2001) Nutrition in inflammatory bowel disease. Curr Opin Clin Nutr Metab Care 4, 561–569.
13. 13. Miranda C. E. Lomer et. Al Nutrition in inflammatory bowel disease Dietary and nutritional considerations for inflammatory bowel diseaseProceedings of the Nutrition Society (2011), 70, 329-335.
14. 14. Approach to the Hypophosphatemic Patient J Clin Endocrinol Metab, March 2012, 97(3): 696-706.
15. 15. Lucendo AJ, De Rezende LC Importance of nutrition in inflammatory bowel disease. Worl J Gastroenterol 2009 May 7;15(17):2081-8.