- M. Marx
- C. Marx
- F.C. Luft
- American Journal of Kidney Diseases
- Am J Kidney Dis 42 (6): 1283-1286
The authors encountered a patient who had profound hypochloremic metabolic alkalosis after developing profuse diarrhea related to rejection of her small bowel transplant. Her ileostomy fluid showed massive electrolyte losses and was exceptionally high in chloride content. She improved with volume substitution and a proton pump inhibitor, although she subsequently required repeat small bowel transplant. The authors speculate that an impaired “downregulated in adenoma” gene (DRA) that enclodes an apical Cl-/HO-(HCO(3)) exchanger may have contributed to an acquired chloridorrhea in this patient.