title: Baking soda pica: a case of hypokalemic metabolic alkalosis and rhabdomyolysis in pregnancy.
abstract: BACKGROUND
  We report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalemic metabolic alkalosis and rhabdomyolysis.
  
  
  METHODS
  A multigravida at 31 weeks of gestation presented with weakness and muscle pain. She was found to have severe hypokalemic metabolic alkalosis and rhabdomyolysis, with elevation in serum transaminases and hypertension. We initially thought the patient had an atypical presentation of preeclampsia until it was realized that she was ingesting 1 full box of baking soda (454 g sodium bicarbonate) per day. Symptoms and abnormal laboratory findings resolved with discontinuation of the patient's pica practices.
  
  
  CONCLUSIONS
  Pica is a common but often overlooked practice that can potentially lead to life-threatening disorders. A thorough evaluation of a patient's dietary intake is extremely important, especially in the setting of atypical presentations of disease in pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA. grotegca@tuhs.temple.edu
authors.forename: Chad A
authors.initials: CA
authors.lastname: Grotegut
authors.forename: Vani
authors.initials: V
authors.lastname: Dandolu
authors.forename: Sunita
authors.initials: S
authors.lastname: Katari
authors.forename: Valerie E
authors.initials: VE
authors.lastname: Whiteman
authors.forename: Ossie
authors.initials: O
authors.lastname: Geifman-Holtzman
authors.forename: Melissa
authors.initials: M
authors.lastname: Teitelman
mesh_terms: D000328:Adult; D000471:Alkalosis / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced*; D010842:Pica / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D012206:Rhabdomyolysis / Q000139:chemically induced*; D017693:Sodium Bicarbonate / Q000009:adverse effects*
chemical_list: D017693:Sodium Bicarbonate