A young person with recurrent severe hypokalaemia - familial, iatrogenic or just unknown?

Abstract

CASE REPORTA 26-year-old female presented with 5-year history of episodic muscle weakness, abdominal cramps and facial paraesthesia. She had 2 hospital admissions elsewhere within 6months with severe hypokalaemia (1.9mmol/L). She was started on Lamotrigine for epilepsy 7 years ago and changed to Levetiracetam in October 2010 following further seizures. She is now seizure-free for over 5 years. Her potassium levels before and after Levetiracetam are shown in Table 1.She had an uneventful childhood. She had no osmotic or urinary symptoms, denied diuretic, laxative, excessive alcohol/liquorice ingestion. No relevant family history. Her body mass index is 22.3, blood pressure 103/55mmHg. Physical examination was unremarkable. Biochemical evaluation is as shown in Table 2. Her genetic screen is awaited.