A 57-year-old woman presented with paresis of the lower limbs of distal onset and installation in hours.
His medical history included hypertension, enalapril, atenolol, and furosemide.
In the previous year, the patient had asymptomatic hypokalemia so oral potassium supplementation was indicated.
The patient was in good general condition, was apyretic and had an AT of 150/90 mmHg.
Neuromuscular evaluation showed quadriparesis predominantly in the lower limbs, with preserved osteotendinous reflexes.
K+pl was 1.4 mEq/L, with potassium in an isolated sample of 26.7 mEq/L and elevated CK.
The diuretic treatment was suspended and hydroelectrolytic replacement was performed obtaining a rapid clinical response with normalization of K+pl and CK values.
In this case, unlike the above, the origin of hypokalemia was renal potassium loss secondary to treatment with loop diuretics.
The finding of 26.7 mEq/L of potassium in an isolated urine sample is consistent with the renal origin of the disorder.
