Hyperkalemia-induced paralysis

Pharmacotherapy. 2009 Oct;29(10):1270-2. doi: 10.1592/phco.29.10.1270.

Abstract

Hyperkalemia is an electrolyte abnormality that can lead to severe consequences. Paralysis induced by hyperkalemia has been described in only a few reports. We describe a 60-year-old man who experienced paralysis presumably due to hyperkalemia. He presented to the emergency department with severe weakness in all extremities. The patient's serum potassium concentration was greater than 8 mEq/L and his serum creatinine concentration was 7 mg/dl. Findings on electrocardiography were abnormal. Of note, his drug therapy included lisinopril and naproxen. After treatment for hyperkalemia, the patient's symptoms resolved; however, he was admitted for further workup for renal failure. The patient was discharged after approximately 1 week with a diagnosis of end-stage renal disease. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 5) between the patient's paralysis and hyperkalemia. Although hyperkalemia as a cause of paralysis is extremely rare, clinicians should be aware of this potentially life-threatening, noncardiac toxicity.

Publication types

  • Case Reports

MeSH terms

  • Creatinine / blood
  • Humans
  • Hyperkalemia / complications*
  • Hyperkalemia / etiology
  • Kidney Failure, Chronic / complications
  • Lisinopril / adverse effects
  • Male
  • Middle Aged
  • Naproxen / adverse effects
  • Paralysis / etiology*

Substances

  • Naproxen
  • Creatinine
  • Lisinopril