Beruflich Dokumente
Kultur Dokumente
HYPOKALEMIA
Bima Yuswanti
Hendy Million
Hypokalemia defined as a plasma K+
concentration < 3.5 mmol/L, may result from
one (or more) of the following : decreased net
intake, shift into cells, or increased net loss.
breakdown
Sarcolemma and T-tubules repolarized
SR terminal cisternae
Actin-myosin crossbridge formation
terminated
Return of tropomyosin to actin binding site
Mg++ complex formed with ATP
Passive sliding of filaments
Sarcomers return to resting state
Hypokalemic Periodic Paralysis
The history of the disease is difficult to trace,
but the first unmistakable account was
probably that of Hartwig in 1874
The usual pattern of inheritance is autosomal
dominant with reduced penetrance in women
(male-to-female ratio of 3 or 4 :1).
Fontaine and coworkes localized the mutation
to a region containing the gene that encodes
alpha subunit of the calcium channel of skeletal
muscle and the gene has now been determined
Mutation in genes and coding three ion
channels [CACNA1S (1q32), SCN4A (17q23.1-
q25.3), and KCNJ2 (17q23.1-q24.2)] account for
most cases.
Hypokalemic periodic paralysis has been
related to mutation in the CACNL1A3, SCN4A,
or KCNE3 (11q13-q14) gene and its
characterized by attacks that tend to occur on
awakening after exercise or after a heavy meal
and may last for several days.
Venance SL. et al. The primary periodic paralysis: diagnosis, pathogenesis, and treatment. Brain. 2006 Jan; 129(Pt
1):8-17. [PMID: 16195244]
Hypokalemic Periodic Paralysis
Paralysis from severe hypokalemia can also
occur in some clinical settings, including
chronic diarrhea, renal tubular acidosis,
primary aldosteronism, and alcoholism.
Certain drug and substance, intoxications, from
licorice, cola, and clay for example, can also
trigger this phenomenon
Up to date
Pathogenesis
How precisely the reduced calcium channel
function relates to hypokalemia-induced
attacks of muscle weakness is not fully known