title: Furosemide-induced severe hypokalemia with rhabdomyolysis without cardiac arrest.
abstract: BACKGROUND
  Hypokalemia induced by diuretic abuse is a life-threatening emergency.
  
  
  METHODS
  A 22-years-old female nurse with a body mass index 18 suffered from myalgias, vomiting and diarrhea. Blood tests revealed hypokalemia with a lowest value of 1.1 mmol/l, moderate hyponatremia, metabolic alkalosis, mild renal insufficiency and creatinphosphokinase-elevation. Since hypokalemia and alkalosis were unexplained, she was asked for diuretic-intake. She confessed that she has taken 250 mg furosemide/day for the last 4 months to improve the shape of her muscles. Furosemide tablets were given to her by a physician attending the gym where she exercised. After electrolyte substitution, laboratory abnormalities regressed and no cardiac arrests were observed. Psychiatric investigation diagnosed an adjustment disorder.
  
  
  CONCLUSIONS
  Furosemide abuse has to be considered even in underweight individuals, especially if they have a psychiatric instability or work in health care institutions.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Ruisz
authors.forename: Claudia
authors.initials: C
authors.lastname: Stöllberger
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
authors.forename: Franz
authors.initials: F
authors.lastname: Weidinger
mesh_terms: D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000009:adverse effects*; D006329:Heart Conduction System / Q000187:drug effects; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis; D011188:Potassium / Q000097:blood; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult
chemical_list: D004232:Diuretics; D005665:Furosemide; D011188:Potassium