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Hyperkalemia-induced acute flaccid paralysis: a case report.
Martina D'Ercole1, Leda Cipriani1, Daniela Picciotto2
1Unit of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine, University of Genova, Genova, Italy.
Summary
Severe hyperkalemia can cause acute flaccid paralysis, a medical emergency. Prompt diagnosis and treatment, including hemodialysis, rapidly resolved paralysis in an elderly patient with kidney failure.
Area of Science:
- Nephrology
- Neurology
- Internal Medicine
Background:
- Acute flaccid paralysis is a critical condition with diverse etiologies, including metabolic derangements.
- Severe hyperkalemia, particularly in elderly patients with renal impairment, is a recognized but often overlooked cause.
Observation:
- A 78-year-old female with hypertension and diabetes presented with rapidly progressing quadriparesis.
- Initial findings included severe hyperkalemia (9.9 mmol/L), metabolic acidosis, kidney failure, and hyperglycemia.
- Electrocardiography revealed characteristic changes of hyperkalemia: absent P-waves, widened QRS, and tall T-waves.
Findings:
- The patient received immediate medical therapy and hemodialysis.
- Neurological deficits and electrocardiographic abnormalities resolved rapidly following treatment.
- This case highlights the direct link between severe hyperkalemia and acute flaccid paralysis.
Implications:
- Early recognition of hyperkalemia is crucial for managing acute flaccid paralysis.
- Hemodialysis is an effective treatment for severe hyperkalemia-induced paralysis.
- This case underscores the importance of considering metabolic causes in paralysis presentations.
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