A cola-induced hypokalemic rhabdomyolysis with electromyographic evaluation: A case report.
OBJECTIVE
To report a rare case of hypokalemic rhabdomyolysis induced by the heavy and prolonged ingestion of cola-based beverages, and its uneventful recovery after kalemia normalization.


METHODS
We report a 38-year-old Caucasian male presented in our emergency room with a recent and progressive weakness of the lower limbs proximal muscles.


RESULTS
A dietary history revealed a prolonged ingestion of cola-based beverages. Blood tests showed severe hypokalemia and marked increase in serum creatine phosphokinase. The analysis of cerebrospinal fluid resulted normal. Electromyography was suggestive for a myopathy. The clinical, laboratory and neurophysiological data were evocative for a cola-induced hypokalemic rhabdomyolysis. After kalemia normalization, the improvements of the electromyographic findings paralleled the clinical recovery.


CONCLUSIONS
Chronic consumption of large amount of cola-based soft drinks may result in severe symptomatic hypokalemia, eventually leading in turn to myopathy. To our knowledge, this is the first description of the electromyographic findings of the cola-induced hypokalemic rhabdomyolysis. An early diagnosis and a prompt treatment appear to be crucial for a benign clinical course.
Department of Neurorehabilitation and Neurological Service, "Moriggia - Pelascini" Hospital, Gravedona ed Uniti (Como), Italy.
Davide
D
Ferrazzoli
Department of Neurorehabilitation and Neurological Service, "Moriggia - Pelascini" Hospital, Gravedona ed Uniti (Como), Italy.
Annarita
A
Sabetta
Department of Neurorehabilitation and Neurological Service, "Moriggia - Pelascini" Hospital, Gravedona ed Uniti (Como), Italy.
Grazia
G
Palamara
Department of Neurorehabilitation and Neurological Service, "Moriggia - Pelascini" Hospital, Gravedona ed Uniti (Como), Italy.
Luca
L
Caremani
Department of Neurorehabilitation and Neurological Service, "Moriggia - Pelascini" Hospital, Gravedona ed Uniti (Como), Italy.
Marina
M
Capobianco
Department of Neurorehabilitation, Scientific Institute of Pavia via Boezio, IRCCS, "Salvatore Maugeri" Foundation, Pavia, Italy.
Pietro
P
Balbi
Department of Neurorehabilitation and Neurological Service, "Moriggia - Pelascini" Hospital, Gravedona ed Uniti (Como), Italy; Fondazione Europea Ricerca Biomedica FERB, "S. Isidoro" Hospital, Bergamo, Italy.
Giuseppe
G
Frazzitta
Coca cola; electromyography; hypokalemic rhabdomyolysis