Atypical Presentation of Gordon Syndrome and Its Management: A Report of Three Patients
Bibliographic record
Abstract
Gordon syndrome (GS) usually presents in children with hyperkalemia, hypertension and hyperchloremic metabolic acidosis. However, it has been reported in adults, where diagnosis can be missed in the absence of vigilance for electrolytes and acid base abnormalities. GS is traditionally managed with hydrochlorothiazide and restricted sodium diet. We report adult patients with GS, who were successfully treated with a potassium-restricted diet. Three female patients (aged 70, 61, and 79 years) presented to the clinic with untreated isolated hyperkalemia for several years. Patients did not complain of headache, palpitation, chest pain, polyuria or hematuria. Upon examination, two patients were normotensive and one patient had hypertension (150/90 mm Hg). Laboratory analysis revealed hyperkalemia (6.2, 6.1 and 6.2 mEq/L), serum bicarbonate level of 30, 27 and 28 mEq/L, hyperchloremia (108, 107 and 94 mEq/L) and serum normal creatinine (0.90, 0.8 and 0.78 mg/dL), based upon normal reference lab values. Plasma aldosterone and renin were normal. Based on patients’ history, physical examination, laboratory findings and absence of other causes of hyperkalemia such as the history of the use of NSAID, ACE inhibitors (angiotensin receptor blockers, aldosterone receptor blockers, and beta-blockers), and the absence of diabetes mellitus and other causes of hyporeninemic hypoaldosteronism, a diagnosis of GS was made. All three patients were treated with a restricted potassium diet contrary to a low sodium diet and hydrochlorothiazide. A 4-week follow-up showed normal serum potassium levels (4.2, 4.6 and 4.9 mEq/L) in all three patients. While GS has been reported previously in adults and can present with normal blood pressure, its management by a restricted potassium diet has not been reported, to the best of our knowledge. GS should be included in the differential diagnosis of adult patients presenting with unexplained hyperkalemia. J Med Cases. 2017;8(8):252-255 doi: https://doi.org/10.14740/jmc2874w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".