Hypochloremia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hypochloremia (or Hypochloraemia) is an electrolyte disturbance whereby there is an abnormally depleted level of the chloride ion in the blood. It rarely occurs in the absence of other abnormalities. If it occurs together with metabolic alkalosis (decreased blood acidity) it is often due to vomiting.

Normal values of Chloride: 99-111 mEq/L (99-111 mmol/L)

Primary anion of extracellular fluid compartment; aids in maintenance of acid-base balance.

Causes

Complete Differential Diagnosis of the Causes of Hypochloremia

In alphabetical order [1] [2]

Complete Differential Diagnosis of the Causes of Hypochloremia

(By organ system)

Cardiovascular Congestive heart failure
Chemical / poisoning No underlying causes
Dermatologic Excessive sweating
Drug Side Effect Aldosterone, Antacid abuse, Bicarbonate containing medication, Corticosteroids, Corticotropin, Laxatives, Loop diuretics, Thiazide diuretics
Ear Nose Throat No underlying causes
Endocrine ACTH-secreting tumors, Adrenal insufficiency, Cushing's syndrome, Diabetic coma, Hyperaldosteronism, Hyponatremia, Pseudohyponatremia, Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Environmental No underlying causes
Gastroenterologic Bulimia nervosa, Diarrhea, Gastric suction, Gastrocolic fistula, Gastroesopahgeal reflux disease, Pyloric stenosis, Villous adenoma, Vomiting
Genetic Cystic fibrosis, Bartter's syndrome
Hematologic No underlying causes
Iatrogenic Excessive saline infusion, Massive blood transfusion, Gastric suction
Infectious Disease No underlying causes
Musculoskeletal / Ortho No underlying causes
Neurologic Excessive sweating
Nutritional / Metabolic Low sodium diet, Metabolic alkalosis, Milk alkali syndrome, Overconsumption of licorice
Obstetric/Gynecologic No underlying causes
Oncologic ACTH-secreting tumors
Opthalmologic No underlying causes
Overdose / Toxicity
Psychiatric Bulimia nervosa
Pulmonary Respiratory losses, Hypoventilation
Renal / Electrolyte Hyponatremia, Renal failure, Salt-losing nephritis, Bartter's syndrome
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma Burns
Urologic Renal failure
Miscellaneous No underlying causes

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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