[Severe hypokalemia with few symptoms disclosing distal renal tubular acidosis].
The case is reported of a 47 year old female patient admitted with asthenia, anorexia, nausea and constipation. The poor clinical features contrasted with the severe biological disturbances: 1 mmol.l-1 serum potassium, pH 7.26, 19 mmHg PaCO2, 8 mmol.l-1 bicarbonate, myoglobinaemia and myoglobinuria. The electrocardiogram showed a flattened T wave, an U wave, and a depressed ST segment. Potassium was given intravenously at a rate of 0.38 mmol.kg-1.h-1 during the first 24 h. Renal biopsy confirmed the diagnosis of distal renal tubular acidosis, but no aetiology could be found. This patient's excellent clinical tolerance of a severe hypokalemia suggested that the potassium pool could be replaced at slower rates than those suggested in the literature for patients with severe symptoms and signs.
Papazian
L
L
Département d'Anesthésie-Réanimation, G.H. Timone-Marseille.
Quinsat
D
D
Costello
R
R
Harle
J R
JR
François
G
G
D000141:Acidosis, Renal Tubular / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged
Hypokaliémie profonde paucisymptomatique révélatrice d'une acidose tubulaire distale.