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 |
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Darci Block, Ph.D. Consultant, Laboratory Medicine and Pathology Mayo Clinic Assistant Professor of Laboratory Medicine and Pathology Mayo Clinic College of Medicine |