A 38-year-old woman presented to the emergency department with generalized myalgia and progressive paresis of the lower limbs, predominantly proximal to one week of evolution.
She had good general condition, adequate cutaneous mucosal hydration, apyrexia and TA of 120 mmHg.
Neuromuscular evaluation revealed impossibility of standing up with proximal paresis of the lower limbs without alteration of the osteotendinous reflexes.
K+pl value was 1.7 mEq/L and CK was elevated.
Electrolytic replacement was initiated with good clinical response and normalization of K+pl and CK 48 h after admission.
In this patient, the finding of a urinary potassium level of 16 mEq/L together with the presence of metabolic alkalosis guided the renal origin of hypokalemia.
