Hypokalemia causing rhabdomyolysis and precordialgia

Prat, Gwénaël; Petrognani, R.; Diatta, Bakary; Dufau, Jean Philippe; Theobald, X.

doi:10.1007/s001340100946

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…In our report, the most notable laboratorial data confirming the presence of amphotericin B-induced tubulopathy included hypomagnesemia, hypokalemia, inability of the kidney to concentrate urine, and increased urinary excretion of potassium. Although other authors have also assessed fractional excretion of electrolytes from 24-hr urine collections [10,13,14], values obtained should not be considered in isolation.…”

Section: Discussionmentioning

confidence: 96%

“…Despite widespread amphotericin B use in clinical practice and the high rate of hypokalemia associated with it, only one adult patient [6] has been reported with hypokalemia-associated rhabdomyolysis induced by amphotericin B. Itraconazole has also been described as a cause of serious hypokalemia leading to rhabdomyolysis [14,16]. Immediate consequences of rhabdomyolysis include hyperkalemia which may cause cardiac dysrythmia and hypocalcemia due to the calcium binding by the damaged muscle proteins and phosphate [11].…”

Section: Discussionmentioning

confidence: 97%

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Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

2006

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Hypokalemia can result in life-threatening complications if not treated appropriately. Although hypokalemia is a frequent adverse effect of amphotericin B therapy, there are no reports in the pediatric literature on hypokalemia-associated rhabdomyolysis induced by this drug. A ten-year-old boy with a history of one week amphotericin B treatment was admitted with weakness of the lower extremities, inability to walk and calf pain. Laboratory tests showed a serum potassium of 1.7 mEq/L and a serum creatinine phosphokinase of 3937 U/L plus myoglobulinuria. Following fluid expansion and intravenous potassium replacement, the patient progressed to achieve full regression of muscular weakness after one week. This report highlights hypokalemia as a rare cause of rhabdomyolysis. Patients on amphotericin B should be checked for this rare yet potentially life-threatening complication.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

2006

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“…A repeated EKG result was normal.Nontraumatic rhabdomyolysis associated with hypokalemia may be a relatively common occurrence 1 and has been documented in several settings. [2][3][4] The mechanism of hypokalemic-induced rhabdomyolysis may relate to the impairment of the physiologic vasodilatory effects mediated by the local release of potassium by skeletal muscle cells. 5 No other obvious cause for rhabdomyolysis in this patient was identified.…”

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confidence: 99%

A case of hypokalemia and rhabdomyolysis in a patient with short bowel syndrome

Guardino¹,

Hix²,

Seidner³

2003

J Parenter Enteral Nutr

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Rhabdomyolysis caused by the metabolic disturbances seen in chronic short bowel syndrome has not been reported in the English literature to our knowledge. Presented is a case of hypokalemic-induced rhabdomyolysis associated with short bowel syndrome.A 48-year-old man was presented to the emergency department with complaints of severe generalized weakness and pain. He had a history of acute aortic dissection with resultant ischemic bowel, necessitating partial resection of the small bowel, ileostomy, and colostomy. He developed chronic diarrhea because of the short bowel syndrome and required parenteral nutrition. This was complicated by multiple episodes of central venous catheter bloodstream infections. For 2 years he demonstrated poor tolerance of oral nutrition; 7 weeks before presentation, he underwent surgical ileocolic anastomosis, with discontinuation of parenteral nutrition. Subsequently, he reported pain and weakness of the extremities, poor appetite, and a weight loss of 14 kg. He denied any fevers, chills, seizures, trauma, vomiting, nausea, contacts with ill individuals, and recent travel, and also denied abuse of diuretics, laxatives, alcohol, or illicit drugs. His medications included metoprolol and codeine, with no recent change in his doses.Physical examination was remarkable for temperature 35.8, pulse 111, respiration 22, and blood pressure 159/86; the patient was a cachectic appearing male. Mucosal membranes were dry, and there was no jugular venous distention. Neuromuscular examination revealed tenderness to palpation at the proximal muscle groups of upper and lower extremities. There was demonstrable weakness of the same muscle groups. Sensation, reflex, and cranial nerve test results were normal.Laboratory data are summarized in Table I. An electrocardiogram (EKG) revealed sinus rhythm and left ventricular hypertrophy with new ST segment changes and U waves.The patient was diagnosed with rhabdomyolysis secondary to hypokalemia. He received IV hydration and potassium replacement totaling 710 mmol. The patient did well and on the day of discharge reported resolution of his symptoms. Follow-up laboratory results are shown in Table I. A repeated EKG result was normal.Nontraumatic rhabdomyolysis associated with hypokalemia may be a relatively common occurrence 1 and has been documented in several settings. 2-4 The mechanism of hypokalemic-induced rhabdomyolysis may relate to the impairment of the physiologic vasodilatory effects mediated by the local release of potassium by skeletal muscle cells. 5 No other obvious cause for rhabdomyolysis in this patient was identified. The presence of short bowel syndrome in this case was a predisposing factor to the development of severe hypokalemia and subsequent rhabdomyolysis. REFERENCES

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Fanconi-like syndrome and rhabdomyolysis in a person with HIV infection on highly active antiretroviral treatment including tenofovir

Callens

2003

Journal of Infection

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Hypokalemia causing rhabdomyolysis and precordialgia

Cited by 5 publications

References 2 publications

Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

A case of hypokalemia and rhabdomyolysis in a patient with short bowel syndrome

Fanconi-like syndrome and rhabdomyolysis in a person with HIV infection on highly active antiretroviral treatment including tenofovir

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