February 2019 — Clinical Chemistry

A 55-year-old female with history of eating disorder and high output ileostomy presented with electrolyte abnormalities, dehydration, chronic kidney failure, and severe QT prolongation. Initial serum lab evaluation revealed severe hypokalemia, hypochloremia, and hypermagnesemia. Stool studies revealed an osmotic cause of diarrhea with fecal osmotic gap of 204 mOsm/kg. Fecal sodium, potassium, chloride, magnesium, and phosphorous were 41 mmol/L, 2 mmol/L, 127 mmol/L, 231 mg/dL, and 3 mg/dL, respectively.

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Kornelia Galior, Ph.D.
Resident, Clinical Chemistry
Mayo Clinic
Darci Block, Ph.D.
Consultant, Laboratory Medicine and Pathology
Mayo Clinic
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine

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