Cases frequently had signs of fluid retention at diagnosis of CAA; however, these clinical signs often emerged after admission to hospital. We speculate that compensatory changes in hydrostatic pressure may be easily overwhelmed with the administration of isotonic fluids. Serum calcium and magnesium are carried by albumin, and there is one reported case of hypomagnesemia and tetany in the literature. In the present series, three cases had documented hypocalcemia and/or hypomagnesemia, of which, two cases were asymptomatic and one had seizures. Also, one case was diagnosed as being vitamin D deficient
The number of cases of CAA in this region of Saskatchewan has increased over the last decade. This increase may have occurred for a number of reasons. Historical marriage patterns by the residents of this region have likely increased the carrier frequency. Furthermore, Saskatchewan Aboriginal women have a higher fertility rate compared with nonAboriginal women (2.6 births per woman and 1.8 births per woman, respectively). Because hospital records were only searched over the last decade and the majority of admissions occured in infancy, some older cases may have been missed. Increased awareness of CAA locally may also contribute to the increased frequency.
All cases in the series were identified during admission to a tertiary care hospital; therefore, it is possible that there may be asymptomatic and undiagnosed cases of CAA within the community, causing us to overestimate the associated morbidity in this population. A second limitation of our case series was the retrospective nature of the study, which meant that health records were incomplete at times. Finally, several of the cases had other medical conditions, including neurometabolic disease, epilepsy, patent ductus arteriosus, and chronic lung disease, which likely increased their morbidity and mortality. Start online shopping right now and see how great it feels to know you are saving more money than you are spending: all that is possible whenever you buy tadalafil online buy now at the best pharmacy you can actually choose yourself right now.