The lady with asymptomatic hyperkalaemia

A middle-aged lady with an asymptomatic, hyperpigmented plaque on the thigh: what is your diagnosis?

CLINICAL PRESENTATIONA 44-year-old lady came to a dermatology clinic due to an asymptomatic, hyperpigmented plaque on her right thigh since 4 months ago. On physical exam, hypertrichosis on the lesion was notable (Figure 1). Rubbing the lesion resulted in erythema and edema of the lesion. She had no systemic disease and her family history was unremarkable.

Hyperkalaemia.

Hyperkalaemia is defined as serum potassium concentration greater than 5.5 mmol/l. Its prevalence in the general population is unknown, but it is thought to occur in 1-10% of patients admitted to hospital.1 The rate of morbidity and mortality associated with hyperkalaemia has risen greatly with the use of drugs that target the renin-angiotensin system, and since publication 10 years ago of a ra...

Treatment of hyperkalaemia with intravenous salbutamol.

Thirteen children with hyperkalaemia were treated by intravenous infusions of salbutamol, 4 micrograms/kg over 20 minutes. Reductions in the mean (SD) plasma potassium concentrations, of 1.48 (0.5) and 1.64 (0.5) mmol/l were obtained at 40 and 120 minutes, respectively, after completion of the infusions. No side effects were noted.

Elderly lady with ascites.

An elderly lady with amylase-rich ascites is presented, whose isoenzyme estimation revealed salivary type amylase. Tumour hyperamylasemia is an important group among the nonpancreatic causes of elevated amylase.

The solemn lady with the lantern.