Low-dose glucocorticoid can lead to hypokalemic paralysis

Glucocorticoids are widely used in clinical practice, and a rare adverse effect of glucocorticoid administration is hypokalemic paralysis. Recently, we experienced two cases of hypokalemic paralysis after low-dose glucocorticoid administration for urticaria in healthy men. Excluding possible endocrinologic disorders, we concluded that hypokalemic paralysis could be attributed to glucocorticoid administration in our patients. Only few cases of hypokalemic paralysis induced by relatively high glucocorticoid dose are reported. In our cases, we suggest that a very low dose of glucocorticoid injection results in hypokalemic paralysis, even in healthy individuals. Clinicians should be aware that a very low dose of glucocorticoid can cause hypokalemic paralysis. Furthermore, when evaluating patient complaints of muscle weakness with hypokalemia, history of glucocorticoid administration should be thoroughly reviewed.