Chlorohydropenic (chloroprivine, hypochloremic) coma

Chlorhydropenic (chloroprivic, hypochloremic) coma is a comatose state that develops as a result of severe disturbances in water-electrolyte balance with significant and prolonged loss of water and salts by the body, primarily chlorine and sodium.

Causes of development of hypochloremic coma

1. Persistent vomiting of any origin (decompensated pyloric stenosis of ulcerative or cancerous etiology; duodenal obstruction; Zollinger-Ellison syndrome - gastrin-producing tumor of the pancreas in combination with a non-healing and often aggravating ulcer of the gastro-duodenal region; brain tumors; intractable vomiting of pregnancy; intestinal obstruction; poisoning; cholelithiasis; acute pancreatitis; kidney disease).
2. Uncontrollable diarrhea of any etiology (toxic infection, enteritis, Crohn's disease, sprue, severe gluten enteropathy, nonspecific ulcerative colitis, cholera and other intestinal infections, irrational use of laxatives).
3. Excessive diuresis due to excessive use of diuretics.
4. Repeated gastric lavage, frequent pleural punctures, paracentesis of the abdominal cavity with removal of a large amount of fluid.

Causes of hypochloremic coma

Symptoms of hypochloremic coma

In most patients, coma develops gradually, most often after prolonged vomiting, diarrhea, and copious diuresis (depending on the underlying disease). In the pre-comatose state, severe weakness, dizziness, severe thirst, dry mouth, palpitations, muscle twitching, and often cramps in the calf muscles are disturbing.

Symptoms of hypochloremic coma

Diagnosis of hypochloremic coma

1. Complete blood count: increased red blood cell and hemoglobin content (blood thickening), hematocrit up to 55% or more, leukocytosis, increased ESR.
2. General urine analysis: decrease in the amount and relative density of urine - proteinuria appears, cylindruria is possible.

Diagnosis of hypochloremic coma