Published online Feb 16, 2017. doi: 10.12998/wjcc.v5.i2.56
Peer-review started: August 16, 2016
First decision: September 28, 2016
Revised: October 17, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: February 16, 2017
Rhabdomyolysis continues to appear with increasing frequency and represents a medical emergency requiring rapid appropriate treatment. One of the unusual causes of nontraumatic rhabdomyolysis is hypokalemic periodic paralysis without secondary causes. Primary hypokalemic periodic paralysis is a rare genetic disease characterized by episodic attacks of muscle weakness due to decreases in serum potassium. A 30-year-old woman who had 3 episodic attacks of hypokalemic periodic paralysis was admitted in emergency room with sudden onset symmetrical muscle weakness. After several hours, she started to complain myalgia and severe ache in both calves without any changes. Laboratory test showed markedly elevated creatine phosphokinase, lactic dehydrogenase levels with hypokalemia, rhabdomyolysis resulting from hypokalemia was diagnosed. Here, we report an unusual case of rhabdomyolysis caused by severe hypokalemia, which was suggested a result of familial hypokalemic periodic paralysis.
Core tip: Familial hypokalemic periodic paralysis is characterized by periodic attacks of muscle weakness due to decreases in serum potassium, caused by genetic defect of potassium-sensitive muscle membrane excitability with familial occurrence. Rhabdomyolysis following severe hypokalemia as the manifestation of familial hypokalemic periodic paralysis is rare, but it occasionally develops acute kidney injury, disseminated intravascular coagulation, arrhythmia as a potentially life threatening complication promptly recognized by the treating physician. The authors pointed to early detection of rhabdomyolysis as a serious complication of severe hypokalemia, and ruling out other causes of hypokalemia by step-wise approach, finally reached the diagnosis with the familial hypokalemic periodic paralysis.