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Betamethasone-induced hypokalemic periodic paralysis in pregnancy
Corey M Teagarden1, Carla W Picardo
1From the Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania; and St. Vincent Health System, Erie, Pennsylvania and the Department of Social Medicine at the University of North Carolina School of Medicine in Chapel Hill, North Carolina.
Background:
Acute hypokalemic periodic paralysis may be induced by betamethasone injections during pregnancy.
Case:
A healthy 23-year-old gravid woman at 32 weeks of gestation with preterm premature rupture of membranes received two doses of 12-mg intramuscular betamethasone 24 hours apart to accelerate fetal lung maturation. She developed significant proximal muscle weakness within 16 hours after the initial dose. Her serum potassium was 1.6 mEq/L. Oral and parenteral potassium replacement restored her neuromuscular function over several days. She delivered by repeat cesarean at 34 weeks of gestation without complications for her or the neonate.
Conclusion:
Hypokalemic periodic paralysis, a rare cause of weakness, may be induced by betamethasone injections during pregnancy and is reversible with low-risk interventions.
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