Life-threatening hypokalaemia and quadriparesis in a patient with ureterosigmoidostomy.
We report quadriparesis as a result of severe hypokalaemia and acidosis in a 50-year-old man who had undergone ureterosigmoidostomy for bladder extrophy 48 years earlier. Aggressive suppletion with intravenous potassium and bicarbonate combined with potassium-sparing diuretics and ACE inhibitors resulted in complete restoration of the serum potassium and resolution of the neurological symptoms. The underlying mechanism as well as the treatment of hypokalaemia and hyperchloraemic metabolic acidosis after ureterosigmoidostomy are briefly discussed.
Van Bekkum
J W
JW
Ikazia Hospital, Department of Internal Medicine, Rotterdam, The Netherlands. J.VANBEKKUM@12MOVE.NL
Bac
D J
DJ
Nienhuis
I E
IE
De Leeuw
P W
PW
Dees
A
A
D000141:Acidosis, Renal Tubular / Q000150:complications / Q000175:diagnosis; D000714:Anastomosis, Surgical; D001639:Bicarbonates / Q000008:administration & dosage; D001746:Bladder Exstrophy / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002712:Chlorides / Q000008:administration & dosage; D012809:Colon, Sigmoid / Q000601:surgery*; D016638:Critical Illness; D006801:Humans; D007008:Hypokalemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007262:Infusions, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000008:administration & dosage; D011379:Prognosis; D011782:Quadriplegia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*
D001639:Bicarbonates; D002712:Chlorides; D008278:Magnesium Sulfate; D011188:Potassium; C001599:chlorite