Disorders of Water and Ions Metabolism

Jaroslava DuškováInst. Pathol. ,1st Med. Faculty,

Charles Univ., Prague

http://www1.lf1.cuni.cz/~jdusk/

General Pathology – Seminar

Body Fluidsintracellular

extracellular

extravascular

intravascular

TBW …total body water

Normal Water Gains & Losses

[~ ml]

Daily Intake

Drinking 1600Food 850Oxidation 350

Total 2800

Daily Otput

Urine 1600Stool 100Skin 300Lungs 800Total 2800

Water Balance Disorders

+ Edema - Dehydration

EdemaDef.: accumulation of fluid intracellular extracellular (interstitial)

Intracellular Edema

energy (ATP) deficiency statuses – hydropic degeneration – vacuolar dystrophy

Na+/K+ dysbalances (hyperaldosteronism)

hypokalaemia in severe diarrhoea hyperhydration - water intoxication

(infusions!)

Starling´s Hypothesis

Net filtration = Forces favoring filtration – Forces opposing filtration

Forces favoring filtration: capillary hydrostatic preassure + intersticial oncotic pressure

Forces opposing filtration: plasma oncotic pressure + tissue hydrostatic pressure

Edema - extracellular

Def.:

accumulation of fluid in the intersticial spaces

Causes & Types of Edema

increased hydrostatic pressure - cardiacdecreased oncotic pressure –hypalbuminoticblocked lymphatics – lymphostaticneuromediators - allergic

Extent: generalized, localized

Filarial diseases

helminthoses (Filaroidea) conveyed by Culex fatigans – common

domestic mosquito rural forms – Anopheles, Aedes lymphatic, subcutaneous tropic and subtropic regions

Bancroftian Filariasis

Wuchereria Bancrofti (man the only definitive host) and Brugia malayi (monkeys, cats, dogs in addition)

Clinic incubation 8-12 mth. lymphangitis eosinophilia lymphedema sef eradication of the disease

when aaway from the endemic area – calcification of worms