Abstract
An: 2021, Nr.2, Articol Nr. 5
Title: 

A DETAIL OF THE MOLECULAR ANATOMY OF THE MUSCLE CELLS AND ITS CLINICAL IMPLICATION

Authors: 

      D. Dragoş, Maria Iuliana Ghenu - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; University Emergency Hospital Bucharest, Romania, 1st Internal Medicine Clinic
      Andra-Elena Balcangiu-Stroescu - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; University Emergency Hospital Bucharest, Romania, Dialysis Department
      Maria Daniela Tănăsescu, D. Ionescu - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; University Emergency Hospital Bucharest, Romania, Nephrology Clinic
      Ileana Adela Văcăroiu - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “St. John” Emergency Clinical Hospital, Bucharest, Romania, Department of Nephrology and Dialys
      A. Tulin - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Faculty of Medicine, Department of Anatomy; “Prof. Dr. Agrippa Ionescu” Clinical Emergency Hospital, Bucharest, Romania, Department of General Surgery
      O. Ştiru - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Faculty of Medicine, Department of Cardiovascular Surgery; “Prof. Dr. C. C. Iliescu” Emergency Institute for Cardiovascular Diseases Bucharest, Romania, Department of Cardiovascular Surgery
      Andrada Mihai - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Faculty of Medicine, Department of Diabetes, Nutrition and Metabolic Disease; “N. C. Paulescu” Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Department II of Diabetes
      Maria Mirabela Manea - “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Faculty of Medicine; National Institute of Neurology and Cerebrovascular Diseases, Bucharest, Romania
      A DETAIL OF THE MOLECULAR ANATOMY OF THE MUSCULAR CELLS AND ITS CLINICAL IMPLICATION (Abstract):The molecular anatomy of muscles cells includes, besides the ubiquitous Na+/K+ ATP-ase, the specific muscle channel Kir2.6, which intervenes as a counter-regulatory mechanism for preventing hypokalemia when Na+/K+ ATP-ase activity is increased, for whatever reason. Hyperthyroidism is such a condition in which the quantitative and qualitative enhancement of Na+/K+ ATP-ase may result in hypokalemia in the rare patient in which Na+/K+ ATP-ase driven potassium entry into the cells is not compensated by an appropriately increased Kir2.6 activity, resulting in potassium depletion of the extracellular space. Severe hypokalemia poses a vital risk by its potential cardiac complications – its correction may be difficult or even impossible as long as the cause, in rare cases hyperthyroidism, is not discovered and dealt with. This paper presents two cases in which unexplainable hypokalemia refractory to substitution treatment raised the suspicion of hyperthyroidism. Antithyroid treatment given after the diagnosis of hyperthyroidism had been confirmed corrected hypokalemia. Conclusions: when confronted with unexplainable hypokalemia, the clinician should consider hyperthyroidism as a possible diagnosis.
Key words: HYPERTHYROIDISM, HYPOKALEMIA, PERIODICAL HYPOKALEMIC PARALYSIS, NA+/K+ ATP-ASE, ANTITHYROID TREATMENT
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