Unusual causes of hypokalaemia and paralysis.
We demonstrate how the application of physiological principles may help to identify unusual causes of a very low plasma potassium (K+) concentration (P(K)) and paralysis. In the two patients described, the short time course of the illness suggested that there was an acute shift of K+ into cells. The combination of a low rate of excretion of K+, the absence of a metabolic acid-base disorder, and the fact that the clinical findings occurred very soon after a large intake of carbohydrate supported this impression. Surprisingly, the P(K) remained low for many hours after these stimuli to shift K+ into cells had abated. The missing link in this story was eventually provided by the attending medical team with the help of their mentor, Professor McCance.
Alazami
M
M
University of Toronto, St Michael's Hospital Annex, Lab #1, Research Wing, 38 Shuter Street, Toronto, Ontario M5B 1A6, Canada.
Lin
S-H
SH
Cheng
C-J
CJ
Davids
M R
MR
Halperin
M L
ML
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects; D000328:Adult; D000661:Amphetamine / Q000009:adverse effects; D002110:Caffeine / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D006801:Humans; D007008:Hypokalemia / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology* / Q000503:physiopathology
D018759:Adrenergic Uptake Inhibitors; D000697:Central Nervous System Stimulants; D002110:Caffeine; D000661:Amphetamine