{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:38Z","timestamp":1756339478384,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,1,1]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>We report a case of a 10-day-old male infant who presented to the emergency department with severe electrolyte imbalance and life-threatening arrhythmia. The parents reported a 3-day history of poor feeding and lethargy. On examination, he was bradycardic (heart rate of 65 beats\/min) with signs of dehydration. His ECG showed broad complex bradycardia. Blood gas showed metabolic acidosis with hyponatraemia and hyperkalaemia. A probable diagnosis of congenital adrenal hyperplasia (CAH) with salt-wasting crisis was made and treatment was commenced. He was given saline bolus, nebulised salbutamol, calcium gluconate and hydrocortisone. Following the above interventions, his heart rate rose to 150 beats\/min with a regular sinus rhythm within a period of 40 min. The diagnosis of CAH secondary to 21-hydroxylase deficiency with mutation in CYP21A2 was confirmed by genetic studies. He was discharged home with hydrocortisone, fludrocortisone and sodium chloride.<\/jats:p>","DOI":"10.1136\/bcr-2018-227565","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T23:09:03Z","timestamp":1548889743000},"page":"e227565","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Congenital adrenal hyperplasia with salt-wasting crisis and arrhythmia: a case study"],"prefix":"10.1136","volume":"12","author":[{"given":"Johnny Figueroa","family":"Canlas","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Ponmani","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,29]]},"reference":[{"key":"2025082707544173000_12.1.e227565.1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/cge.13078","article-title":"A genetic epidemiology study of congenital adrenal hyperplasia in Italy","volume":"93","author":"Gialluisi","year":"2018","journal-title":"Clin Genet"},{"doi-asserted-by":"publisher","key":"2025082707544173000_12.1.e227565.2","DOI":"10.1210\/er.21.3.245"},{"key":"2025082707544173000_12.1.e227565.3","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1177\/1074840717735499","article-title":"How the child\u2019s gender matters for families having a child with congenital adrenal hyperplasia","volume":"23","author":"Fleming","year":"2017","journal-title":"J Fam Nurs"},{"doi-asserted-by":"publisher","key":"2025082707544173000_12.1.e227565.4","DOI":"10.1210\/jc.86.7.2958"},{"key":"2025082707544173000_12.1.e227565.5","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.phrs.2016.09.039","article-title":"Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future","volume":"113","author":"Rossignol","year":"2016","journal-title":"Pharmacol Res"},{"doi-asserted-by":"publisher","key":"2025082707544173000_12.1.e227565.6","DOI":"10.1097\/CCM.0b013e31818f222b"},{"doi-asserted-by":"publisher","key":"2025082707544173000_12.1.e227565.7","DOI":"10.1136\/archdischild-2011-300623"},{"key":"2025082707544173000_12.1.e227565.8","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1297\/cpe.24.77","article-title":"Guidelines for diagnosis and treatment of 21-hydroxylase deficiency (2014 revision)","volume":"24","author":"Ishii","year":"2015","journal-title":"Clin Pediatr Endocrinol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227565","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:54:50Z","timestamp":1756306490000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,29]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/bcr-2018-227565"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227565","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}