[A case of itraconazole-induced hypokalemia with pulmonary aspergilloma]

A case of itraconazole-induced hypokalemia with pulmonary aspergilloma is reported. A 68-year-old female who had been followed for rheumatoid arthritis, gastric ulcer and pulmonary aspergilloma was admitted to our hospital because of a cough, low grade fever and hemosputum. She was treated with itraconazole (100 mg/day) for pulmonary aspergilloma of the left upper lobe. Fifty seven days after starting the treatment, her serum potassium was 2.33 mEq/l. Since there was no history of diarrhea, vomiting or abuse of drugs known to cause hypokalemia, itraconazole- induced hypokalemia was suspected. Thirty one days after the discontinuation of the treatment with itraconazole, her serum potassium increased to 3.57 mEq/l without potassium supplement. The lymphocyte stimulation test for itraconazole was negative. This case suggests that serum potassium should be monitored in the patients treated with itraconazole.