Furosemide-Induced Severe Hypokalemia With Rhabdomyolysis Without Cardiac Arrest

Wolfgang Ruisz; Claudia Stöllberger; Josef Finsterer; Franz Weidinger

BMC Womens Health. 2013;13(30)

Conclusions

This case shows that furosemide-induced severe hypokalemia may present without cardiac arrest, may be survived without sequelae and may be accompanied by transient rhabdomyolysis. Chronic furosemide abuse in order to lose weight has to be considered even in underweight individuals, especially if they have a psychiatric instability or work in health care institutions.

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Table 1. Laboratory findings
Parameter	Reference value	Day 1	Day 1	Day 2	Day 2	Day 3	Day 3	Day 5	Day 7	Day 8	Day 15
		12:02	22:58	05:47	21.38	07:42	18:10	09:45	10:42	08:08	12:21
BUN	9.0–20.0 mg/dl	25	21	21	NM	12	9	4	6	8	14
Creatinine	−1.1 mg/dl	1.64	1.15	NM	NM	0.87	1.00	0.74	0.80	0.84	0.81
GFR	>90 ml/min/1.73 m	42	63	NM	NM	87	74	104	95	90	94
Sodium	136.0–145.0 mmol/l	130	129	132	132	138	136	137	140	140	139
Potassium	3.3–5.1 mmol/l	1.1	1.6	1.5	1.4	1.7	2.8	4.5	5.4	4.9	5.0
Chloride	98.0–106.0 mmol/l	90	92	97	98	101	97	100	NM	NM	99
Calcium	2.1–2.7 mmol/l	2.66	2.0	2.0	2.0	2.1	2.0	2.1	NM	NM	2.8
pH	7.33–7.42	7.549	7.514	7.468	7.454	7.357	7.453	7.467	NM	NM	7.371
HCO₃ ⁻	22–26 mmol/l	31.4	28.6	29.0	28.4	25.3	30.9	33.3	NM	NM	29.0
P_CO2	38–42 mmHg	36.1	34.2	40.9	42.3	52.1	48.0	35.7	NM	NM	57.0
CK	−144.0 U/l	15966	13143	11570	NM	9882	12043	5703	1867	1070	102
Leukocytes	4.0–9.0/nl	18.1	NM	NM	NM	9.5	8.9	NM	NM	5.5	5.9
Erythrocytes	4.0–5.2/pl	5.19	NM	NM	NM	3.28	3.48	NM	NM	3.54	3.55
Hemoglobin	12.0–16.0 g/dl	16.6	NM	NM	NM	10.4	11.2	NM	NM	11.4	12.1
Hematocrit	38.0–48.0%	42.7	NM	NM	NM	27.8	29.6	NM	NM	35.0	35.2

GFR = glomerular filtration rate, estimated according the Modified Diet in Renal Disease formula; CK = Creatinphosphokinase.

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Furosemide-Induced Severe Hypokalemia With Rhabdomyolysis Without Cardiac Arrest

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Authors and Disclosures

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