Acetazolamide-induced muscle weakness in hypokalemic periodic paralysis.
A 46-year-old man with hypokalemic periodic paralysis (HypoPP) and diabetes mellitus (DM) had worsened muscle weakness after acetazolamide (ACZ) treatment. During the paralytic episode, serum potassium levels were reduced, and serum chloride and insulin levels were increased. The data suggested proximal renal tubular acidosis due to ACZ. We determined arterial-venous concentrations of potassium, insulin and glucose across the forearm. Venous potassium levels were markedly reduced. ACZ is thought to potentiate potassium uptake into muscles. Hyperinsulinemia and DM could contribute to ACZ-induced exacerbation in our patient. We should pay more attention to ACZ-treated HypoPP patients with hyperinsulinemia and DM.
D000086:Acetazolamide / Q000009:adverse effects*; D000141:Acidosis, Renal Tubular / Q000150:complications / Q000188:drug therapy; D001786:Blood Glucose; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D004232:Diuretics / Q000009:adverse effects*; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications* / Q000188:drug therapy; D020514:Hypokalemic Periodic Paralysis / Q000150:complications* / Q000188:drug therapy; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000139:chemically induced* / Q000188:drug therapy; D011188:Potassium / Q000097:blood; D016896:Treatment Outcome; D014223:Triamterene / Q000627:therapeutic use
D001786:Blood Glucose; D004232:Diuretics; D007328:Insulin; D000086:Acetazolamide; D011188:Potassium; D014223:Triamterene