A Case of Severe Hypokalemia Induced by Chronic Furosemide Abuse.
- Author:
Young Sook LEE
1
;
You Hyun LEE
;
Youn Jung KIM
;
Jung Mee KWON
;
Seong Nam KIM
;
Duk Hee KANG
;
Si Hoon PARK
;
Kyu Bok CHOI
;
Kyun Il YOON
;
Sun Hee SUNG
Author Information
1. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. kbchoi@mm.ewha.ac.kr
- Publication Type:Case Report
- Keywords:
Hypokalemia;
2 : 1 AV block
- MeSH:
Atrioventricular Block;
Biopsy;
Blood Pressure;
Creatine;
Echocardiography;
Electrocardiography;
Emergency Service, Hospital;
Female;
Furosemide*;
Glucose Intolerance;
Heart Rate;
Humans;
Hypokalemia*;
Intestinal Pseudo-Obstruction;
Juxtaglomerular Apparatus;
Kidney;
Middle Aged;
Muscle Weakness;
Nephrocalcinosis;
Nephrosis;
Pleural Effusion;
Potassium;
Potassium Chloride;
Prescriptions;
Tablets;
Tomography, X-Ray Computed
- From:Korean Journal of Nephrology
2002;21(5):847-854
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 46-year-old woman was admitted to emergency room for muscle weakness and repiratory difficulty. She was taking furosemide (4 tablets per day : 160 mg/day) without physician's prescription. Her blood pressure was 90/50 mmHg and her heart rate 74/ min. Her laboratory finding showed a low serum potassium concentration (0.9 mmol/L), CK 368 IU/L, creatine 1.6 mg/dL. The result was rechecked and confirmed. Electrocardiography showed a dip in the ST segment, prolonged QTc, 1st degree AV block and 2 : 1 AV block. Echocardiography was normal. Abdominal CT scan show right lower pole calyceal stones without nephrocalcinosis. Treatment was initiated consisting of intravenous potassium chloride. Hypokalemia was overcome in 3 days. Kidney biopsy showed hypokalemic nephropathy - interstitial nephrosis, vacuolar change of tubule, proliferation of juxtaglomerular apparatus. Paralytic ileus, rebound pleural effusion, glucose intolerance, elevation of CK were associated findings. After correction of hypokalemia, her symptoms and electrocardiographic findings returned to normal.
