Symptomatic hypokalemia resulting from surreptitious diuretic ingestion

We report five cases of symptomatic hypokalemia caused by surreptitious diuretic ingestion. A positive diagnosis was made in four patients by a colorimetric detection of the diuretic in urine by simple chemical means. Patients who surreptitiously ingest diuretics appear to be mainly women, among whom there appears to be high prevalence of diagnoses involving the reproductive system. Many of these patients have health-related occupations. They seem to be very concerned with appearing obese or edematous. A high urine potassium level in the presence of a low serum potassium level can suggest this diagnosis.