Case Report
Volume 10 Issue 12 - 2021
A Rare Case of Neonatal Hypochloremic Metabolic Alkalosis Causing Hypoxia and Hyperlactatemia Secondary to a Probable Underlying Maternal Reason
Aya Habbal1, Nadia Hamwi1 and Mustafa Alabdullatif2*
1Academic Affair Department, Tawam Hospital, Al Ain, UAE
2Neonatal Intensive Care Unit Department, Tawam Hospital, Al Ain, UAE
*Corresponding Author: Mustafa Alabdullatif, Neonatal Intensive Care Unit Department, Tawam Hospital, Al Ain, UAE.
Received: October 27, 2021; Published: November 19, 2021




Abstract

Metabolic alkalosis in neonates within few hours of life is extremely rare. The most common causes of metabolic alkalosis in neonates can be attributed to vomiting, diuretic use, Bartter syndrome and maternal hypochloremia. There have been a few reported cases describing neonatal metabolic alkalosis.

We will be presenting a unique case of a male neonate that was found have tachypnea with shallow breathing, and desaturations at 7 hours of life, extensive workup was done and revealed normal serum sodium (Na 134) mmol/L and potassium levels (K 3.9 mmol/L), low serum chloride (Cl 79 mmol/L), urine chloride of < 50 mmol/L, high lactate of 9.6 mmol/L and metabolic alkalosis (blood gas pH 7.54, PCO2 35.2 mmHg, HCO3 44 mmol/L, BE 16.1 mmol/L). Within three days of life lactate level and electrolytes started to normalize. Maternal history was significant for frequent hospital admissions due to undiagnosed hypokalemia. Eventually postnatal as part of the neonatal management, the requested maternal labs showed hypokalemia of 2.3 mmol, hypomagnesaemia of 0.64 mmol/L, hypochloremia of 77 mmol/L and metabolic alkalosis (pH 7.55, PCO2 53.2 mmHg, HCO3 47 mmol/L). She is currently under workup for possible Gitelman syndrome.

Our case highlights the importance of evaluation of maternal electrolyte derangement and acid-base disturbances during neonatal management of metabolic acidosis in the first few days of life. Metabolic alkalosis may present with hypoxic and hypoperfusion status.

Keywords: Metabolic Alkalosis; Hypochloremia; Hyperlactatemia; Neonate; Neonatal Hypoxia

Citation: Mustafa Alabdullatif., et al. ““A Rare Case of Neonatal Hypochloremic Metabolic Alkalosis Causing Hypoxia and Hyperlactatemia Secondary to a Probable Underlying Maternal Reason”. EC Paediatrics 10.12 (2021): 51-54.

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