Internal Medicine

0521779407-13 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:15

Liddle’s Syndrome Liver Fluke Infections 907

LIDDLE’S SYNDROME

MICHEL BAUM, MD

history & physical

■Hypertension with family history of hypertension

■Autosomal dominant inheritance

tests

■Hypokalemic alkalosis with low plasma aldosterone and renin

differential diagnosis

■Distinguish from other causes of hypertension

■Due to mutation in collecting tubule Na channel with an increase in

Na channel activity

management

■Low-salt diet

specific therapy

■Amiloride or triamterene

follow-up

■For management of hypertension

complications and prognosis

■Secondary to hypertension

LIVER FLUKE INFECTIONS

J. GORDON FRIERSON, MD

history & physical

History

■Life cycle: Adults of Chlonorchis sinensis and Opisthorchis viverini

live in biliary tree and lay eggs, which pass to fresh water and hatch.

The larvae enter snails, multiply, and are released to water as cer-

cariae. They penetrate to muscle of fish and encyst.

➣Exposure: eating poorly cooked or raw fish. Larvae migrate to

biliary tree, mature there.

Signs & Symptoms

■In acute infection, RUQ pain, fever, abdominal swelling, myal-

gias, rash, lymphadenopathy, urticaria. Examination shows hepato-

megaly and tender liver, may be jaundice, rashes. In chronic