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Abstract: A 26-year-old Ms. Wang was sent to our hospital by her family for sudden collapse, showing general weakness, pallor, nausea and vomiting, and hypokalemia was suspected by electrocardiogram examination. After hospitalization, she was diagnosed with hypokalemia through physical examination and laboratory tests, which showed that her tendon reflexes were absent and her blood and urine potassium were lower than normal. After 1 week of intravenous and oral potassium supplementation, Ms. Wang was discharged from the hospital with relief of the above-mentioned symptoms.
Basic information】Female, 26 years old
Disease Type】Hypokalemia
Hospital】Beijing Anzhen Hospital, Capital Medical University
Date of Consultation】May 2019
Treatment plan】Intravenous injection (fat milk injection (C14-24), 5% glucose injection, 15% KCI10) + oral medication (potassium chloride extended-release tablets)
Treatment period】1 week of hospitalization
Effectiveness of treatment】After 1 week, the blood potassium level returned to normal and the somatic symptoms gradually disappeared.
I. Initial consultation
She was sent to the hospital by her family. She was in a poor mental state, complaining of general weakness with nausea and vomiting, etc. Her family told her that she had been on a diet recently, sometimes she vomited after eating, her meals were very irregular, she drank less water, and she often did a lot of strenuous exercise. After observing Ms. Wang’s pale face and abnormal appearance, she was immediately given an electrocardiogram and was found to have U waves, which was suspected to be hypokalemia.
II. Treatment process
After hospitalization, the physical examination, routine blood and urine tests were completed, and it was found that the tendon reflexes disappeared and the blood potassium concentration was 2.59 mmol/L. The hypokalemia was considered to be related to Ms. Wang’s recent excessive dieting and weight loss, which led to low potassium intake and excessive potassium loss due to frequent vomiting and excessive sweating after strenuous exercise. During her hospitalization, she was treated intravenously with fat milk injection (C14-24), 5% glucose injection + 15% KCI IV, followed by oral potassium chloride extended-release tablets, and regular monitoring of her vital signs, blood potassium concentration and urine output. At the same time, Ms. Wang was instructed to gradually resume normal eating and can now eat more potassium-rich foods to prevent the recurrence of hypokalemia.
Treatment effect
After 1 week of treatment, Ms. Wang’s mental state improved more than when she was admitted to the hospital, and her nausea, vomiting, weakness and other uncomfortable symptoms gradually disappeared.
IV. Notes
I am glad that Ms. Wang’s symptoms of hypokalemia were corrected in time, but I would like to advise her to take more food with high potassium content, such as potatoes, raisins, celery, purple cabbage, carp, etc. She should relax and look at her body shape correctly after discharge from the hospital, and not to lose weight excessively.
V. Personal insight
Hypokalemia is usually related to insufficient potassium supplementation or excessive potassium excretion. In this case, Ms. Wang mainly suffered from two-way potassium loss due to excessive dieting, which led to the onset of the disease. Ms. Wang’s experience can warn us to pay attention to a reasonable daily diet, diversify nutrition, and avoid excessive dieting to avoid hypokalemia or malnutrition.