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- Title
Spectrum of Hypokalemic Paralysis from a Tertiary Care Center in India.
- Authors
Chandramohan, G.; Dineshkumar, T.; Arul, R.; Seenivasan, M.; Dhanapriya, J.; Sakthirajan, R.; Balasubramaniyan, T.; Gopalakrishnan, N.
- Abstract
Hypokalemic paralysis is an important and reversible cause of acute flaccid paralysis. The treating physician faces unique diagnostic and therapeutic challenges. We did a prospective study and included all patients with acute flaccid weakness and documented serum potassium of <3.5 mEq/L during the period between January 2009 and August 2015. We studied the incidence, etiology, clinical profile, and acid--base disturbances in patients presenting with hypokalemic paralysis and analyzed the significance of periodic and non-periodic forms of hypokalemic paralysis on patient's outcome. Two hundred and six patients were studied with a mean follow-up of 3.6 ± 1.2 years. Mean age was 37.61 ± 2.2 years (range 18--50 years). Males were predominant (M:F ratio 2.1:1). The nonperiodic form of hypokalemic paralysis was the most common (61%). Eighty-one (39%) patients had metabolic acidosis, 78 (38%) had normal acid--base status, and 47 (23%) patients had metabolic alkalosis. The most common secondary cause was distal renal tubular acidosis (RTA) (n = 75, 36%), followed by Gitelman syndrome (n = 39, 18%), thyrotoxic paralysis (n = 8, 4%), hyperaldosteronism (n = 7, 3%), and proximal RTA (n = 6, 4%). Patients with non-periodic paralysis had more urinary loss (40.1 vs. 12.2 mmol, P = 0.04), more requirement of potassium replacement (120 vs. 48 mmol, P = 0.05), and longer recovery time of weakness (48.1 vs. 16.5 h, P = 0.05) than patients with periodic paralysis. Non-periodic form of hypokalemic paralysis was the most common variant in our study. Patients with periodic paralysis had significant incidence of rebound hyperkalemia.
- Subjects
INDIA; HYPOKALEMIA; LONGITUDINAL method; PARALYSIS; ACUTE flaccid paralysis; TERTIARY care; DISEASE complications; DISEASE risk factors
- Publication
Indian Journal of Nephrology, 2018, Vol 28, Issue 5, p365
- ISSN
0971-4065
- Publication type
Article
- DOI
10.4103/ijn.IJN_225_17