pyrophosphate and Alkalosis

A patient with hypokalemic metabolic alkalosis, hypophosphatemia, and hypomagnesemia/hypocalcemia is described. Electrocardiography demonstrated the pattern of acute anterior myocardial infarction. Further evaluation revealed that the patient had not actually had the acute myocardial infarction and that the electrocardiographic change was a mere simulation. The possible role of hypomagnesemia in the pathogenesis of the electrocardiographic change and the interrelation between the metabolic disturbances noted are discussed.

Topics: Alkalosis; Diagnosis, Differential; Diphosphates; Electrocardiography; Humans; Hypocalcemia; Hypokalemia; Hypophosphatemia, Familial; Magnesium; Male; Metabolism, Inborn Errors; Middle Aged; Myocardial Infarction; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

In two cases of Bartter's syndrome with hypomagnesaemia the authors report radiological findings typical of chondrocalcinosis associated with joint symptoms corresponding to this condition. In Bartter's syndrome there is, in addition to hypokalaemic alkalosis, often concomitant magnesium depletion which has marked repercussions with respect to both physiopathology and symptomatology. In particular, hypomagnesaemia could well be important in the pathogenesis of chondrocalcinosis through two simultaneous mechanisms: by reducing the activity of pyrophosphatases and by facilitating the crystallisation of pyrophosphates. These mechanisms could explain the association of Bartter's syndrome and chondrocalcinosis, which is described here for the first time.

Topics: Adult; Alkalosis; Bartter Syndrome; Chondrocalcinosis; Crystallization; Diphosphates; Female; Humans; Hyperaldosteronism; Hypokalemia; Magnesium Deficiency; Male; Potassium; Pyrophosphatases