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頁籤選單縮合
題 名 | An Easily Missed Cause of Hypokalemia and Paralysis: Chronic Glue-Sniffing=一個容易被忽略的造成低血鉀麻痺病因:慢性吸食強力膠 |
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作 者 | 唐士恩; 鄭智仁; 林石化; | 書刊名 | Journal of Medical Sciences |
卷 期 | 27:1 2007.02[民96.02] |
頁 次 | 頁37-40 |
分類號 | 415.597 |
關鍵詞 | 低血鉀; 麻痺; 強力膠; Glue-sniffing; Hypokalemia; Paralysis; Renal tubular acidosis; |
語 文 | 英文(English) |
英文摘要 | Chronic glue-sniffing for illegal recreation is a little-recognized but reversible cause of hypokalemia and paralysis. We report a case of a 28-year-old obese Chinese female who suffered from repetitive inability to ambulate upon waking in the morning. She presented to the emergency department with proximal muscle weakness and symmetrical areflexia of all four limbs. The major biochemical abnormalities were profound hypokalemia (1.8 mmol/L) with elevated urinary K+ excretion (urine K+ concentration ÷ urine creatinine concentration = 5.7 mmol/mmol) and hyperchloremic metabolic acidosis (pH 7.25; HCO3 , 14.0 mmol/L; Cl-, 112 mmol/L). A negative urinary anion gap and high urinary ammonium excretion suggested that renal tubular acidosis was not present. When questioned about her drug history, the patient admitted to habitual daily glue-sniffing for six months. After cessation of glue-sniffing and supplementation with a large quantity of potassium chloride (860 mmol), her muscle strength returned and her serum K+ concentration increased to 4.2 mmol/L without further recurrence. Chronic glue-sniffing should be considered when patients present with unexplained hypokalemic paralysis. |
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