Dr. Ilgar Taşdemir, Hacettepe Hastanesi, Nefroloji Bðlümü, Kat. I, Hacettepe/Ankara (Turkey) Sir, Acquired selective aldosterone deficiency in adult patients is a rare clinical entity, in which adrenal production of aldosterone is reduced without associated reduction in production of cortisol [1]. Since the original case reported by Hudson et al. [2], about 50 additional cases have been describ...

To the Editor, I read with great interest the study by Hojo et al. [1], published in the Journal, about a 74-year-old woman with bouts of polymorphic ventricular tachycardia (PVT) in the setting of Takotsubo syndrome (TTS) who was found to be hypokalemic and had prominent T-wave and J-wave electrical alternans, and mechanical alternans. The following are some thoughts and questions for the auth...

Normal hearts exhibit a positive time difference between the end of ventricular contraction and the end of QT interval, which is referred to as the electromechanical (EM) window. Drug-induced prolongation of repolarization may lead to the negative EM window, which was proposed to be a novel proarrhythmic marker. This study examined whether abnormal changes in the EM window may account for arrhy...

BACKGROUND periodic paralysis related to hypokalemia is seldom reported in thyrotoxicosis, and it usually occurs in Asian males. PATIENTS AND METHODS Two Romanian (Caucasian) young patients presented with hypokalemic paralysis. TSH, FT4, TT3 was measured by immunochemiluminescence. Case report 1. Patient O.R, aged 19, presented marked asthenia and lower limbs paralysis, following high carbohy...

Most causes of hypokalemia are obvious from the clinical picture and the values for plasma electrolytes. In cases with obscure etiology, a pretreatment estimation of urinary potassium and chloride often helps lead the clinician into new and fruitful avenues of clinical investigation. Here we present four cases of hypokalemia in which the pathogenesis was initially enigmatic but was clarified so...

Joel T Levis, MD, PhD, FACEP, FAAEM, is a Senior Emergency Medicine Physician at the Santa Clara Medical Center, and Clinical Instructor of Emergency Medicine (Surgery) at Stanford University. He is the Medical Director for the Foothill College Paramedic Program in Los Altos, CA. E-mail: [email protected]. Figure 1. 12-lead ECG from a 21-year-old man with syncope, generalized weakness, and seve...

Typical adverse effects of Shakuyaku-kanzo-To (SKT), an herbal medicine containing licorice, is a licorice-induced pseudoaldosteronism with hypokalemia and hypertension. The risk factors for this side effect are still unclear. To identify the risk factors, we surveyed 37 cases of licorice-induced pseudoaldosteronism in the literature and serum potassium levels in our patients receiving SKT and ...

CONTEXT Taxine-derived alkaloids, taxane-derived substances, and glycosides seem to be responsible for the toxicity of Taxus spp. by blocking microtubule, sodium and calcium channels causing conduction abnormalities. Cases with Taxus baccata acute intoxication have rarely been reported. CASE DETAILS We report the case of a 43-year-old man who ingested, for suicidal purposes, common (or Europe...

BACKGROUND Hypokalemia is not an isolated disease but an associated finding in a number of different diseases. It is also a commonly neglected condition among patients with acute acetaminophen overdose. OBJECTIVES This study intended to determine the prevalence of hypokalemia and its clinical correlates in acute psychiatric illness among hypokalemic and normokalemic patients after acetaminoph...

Self-treatment of cancer with cesium chloride, despite proven lack of efficacy, continues to produce serious adverse effects. Among these is hypokalemia predisposing to life-threatening arrhythmia. The mechanism of cesium-associated hypokalemia (CAH) has not been described. We report urinary potassium wasting responsive to amiloride therapy in a cancer patient with CAH, and discuss possible mec...