muramidase and Hypokalemia

Topics: Blast Crisis; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukemia, Myelomonocytic, Chronic; Male; Middle Aged; Muramidase

Topics: Female; Humans; Hypokalemia; Leukemia, Myeloid; Middle Aged; Muramidase

Forty-two patients with acute myelogenous leukemia or one of its variants were studied at diagnosis to determine the incidence and cause(s) of hypokalemia. Forty-three percent of patients were hypokalemic, and an inappropriate renal loss of potassium was noted. This potassium wastage could not be explained by antibiotic-induced renal tubular dysfunction, lysozymuria, or alterations in renin-aldosterone secretion.

Topics: Aldosterone; Anti-Bacterial Agents; Female; Humans; Hypokalemia; Kidney Tubules; Leukemia, Myeloid, Acute; Male; Middle Aged; Muramidase; Potassium; Renin; Sodium

Hypokalemia has been noted as a frequent complication of acute leukemia. To our knowledge, an association of this electrolyte disturbance with chronic myelogenous leukemia (CML), not in blast crisis, has never been reported. We report a unique case of hypokalemia that complicated the clinical course of a patient with nonblastic CML. The pathogenesis of the hypokalemia was shown to be inappropriate hyperkaluresis, which appeared to be related to lysozymuria and a large tumor burden. We discuss the pathogenesis of hypokalemia in leukemia. We think that the unusual features associated with CML in this case make a large tumor burden their most likely underlying cause. This may help explain the still confusing and unresolved relationship between lysozymuria and potassium wasting in leukemia.

Topics: Humans; Hypokalemia; Leukemia, Myeloid; Male; Middle Aged; Muramidase; Potassium

Topics: Humans; Hypokalemia; Leukemia, Myeloid, Acute; Muramidase; Sarcoidosis; Tuberculosis

In a consecutive series of 22 patients with acute leukemia, the total body potassium was studied in 18 patients on 39 occasions during relapse and remission. Total body water was also determined. A control group consisting of 88 age-matched healthy volunteers was also studied. The patients had a significantly lower mean potassium concentration, per kg body weight, per kg lean body mass and per kg water, than the controls (p less than 0.001). Individually, 11 out of the 18 patients had at least one value below the lower 95% confidence limit. Hypokalemia was frequent both in the patients with low (7/11) and normal (3/6) potassium per kg lean body mass. Five of 13 investigated patients showed laboratory indications of secondary hyperaldosteronism, which might be partly responsible for the hypokalemia. Increased serum or urine levels of lysozyme were found in 62% of the patients.

Topics: Adult; Aged; Aldosterone; Antineoplastic Agents; Electrolytes; Female; Humans; Hypokalemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Middle Aged; Muramidase; Potassium; Renin

Serum lysozyme (muramidase) estimation is a simple, convenient and useful laboratory investigation. A review of the literature shows that lysozyme has been implicated as an aetiological factor in various disorders, and credited with being a prognostic indicator in acute myeloid leukaemia, but these promises have not been fulfilled. This low molecular weight protein is found in the urine of some patients with renal tubular disorders, but some workers have emphasized its importance as a causal agent in hypokalaemia of acute myeloid leukaemia. Research should be concentrated on muramidase as an expression of cell functions rather than as an aetiological factor. Hypokalaemia in acute myeloid leukaemia may be caused by an unidentified substance of molecular weight similar to that of lysozyme.

Topics: Animals; Humans; Hypokalemia; Kidney Diseases; Leukemia, Myeloid, Acute; Muramidase; Prognosis

Twenty cases of acute monoblastic leukemia are studied according to definite criterias: cytology, cytochemical staining, lysozyme production. The study points out the tumoral characters: hematodermy, gingivitis, central nervous system leukemia and the lack of important bone marrow incompetence. 47 per cent of complete remissions are obtained with daunorubicin, aracytin combination therapy. Other useful chemical agents, and prospects for maintenance therapy are discussed.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Cytarabine; Daunorubicin; Disseminated Intravascular Coagulation; Female; Gingiva; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Male; Middle Aged; Muramidase; Potassium; Splenomegaly

Topics: Aldosterone; Humans; Hydrocortisone; Hydrogen-Ion Concentration; Hypokalemia; Kidney; Leukemia, Myeloid, Acute; Muramidase; Potassium; Proteinuria

Topics: Animals; Disease Models, Animal; Humans; Hypokalemia; Leukemia, Myeloid, Acute; Muramidase; Rats

Topics: Acute Kidney Injury; Female; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Middle Aged; Muramidase

On the assumption that increased urinary lysozyme concentration (;lysozymuria') indicates tubular proteinuria and therefore impaired tubular function, urinary lysozyme has been estimated in acute disorders where transient disturbances of renal function might be expected, in cases diagnosed clinically as extrarenal uraemia, and in a few examples of acute renal disease. Reversible lysozymuria occurred with hypokalaemia, postoperative ;collapse', electrolyte depletion, severe extrarenal infection, acute pyelonephritis, the nephrotic syndrome, after a few apparently uncomplicated surgical operations, and very transiently after ventricular fibrillation abolished by DC shock. There was no lysozymuria with severe uraemic heart failure, aspirin and paracetamol poisoning, or severe jaundice, nor in two cases of acute glomerulonephritis. Although lysozymuria may occasionally be useful in the clinical diagnosis of acutely disordered renal function, the results suggest that its value is limited; on the other hand, they have provided information on renal pathophysiology in acute disease.

Topics: Acetaminophen; Acute Disease; Aspirin; Electroshock; Glomerulonephritis; Heart Failure; Humans; Hypokalemia; Jaundice; Kidney; Kidney Diseases; Kidney Failure, Chronic; Kidney Tubules; Muramidase; Myocardial Infarction; Nephrotic Syndrome; Pneumonia; Postoperative Complications; Proteinuria; Pyelonephritis; Uremia; Ventricular Fibrillation

Topics: Adult; Aged; Blood Urea Nitrogen; Female; Humans; Hypokalemia; Kidney Tubules; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Male; Middle Aged; Muramidase; Myeloproliferative Disorders; Polycythemia Vera; Primary Myelofibrosis; Radiography; Spleen

Topics: Animals; Disease Models, Animal; Hypokalemia; Kidney; Kidney Tubules; Leukemia, Myeloid; Muramidase; Neoplasm Transplantation; Potassium; Rats

Topics: Adult; Female; Hematologic Diseases; Humans; Hypokalemia; Leukemia; Leukemia, Myeloid; Male; Muramidase

Topics: Acidosis, Renal Tubular; Adult; Aged; Ammonia; Calcium; Chlorides; Creatinine; Female; Humans; Hydrogen-Ion Concentration; Hypokalemia; Kidney Diseases; Kidney Tubules; Leukemia, Myeloid; Magnesium; Male; Middle Aged; Muramidase; Phosphates; Uric Acid; Urine