Introduction

Rhabdomyolysis- the dissolution of striped skeletal muscle is characterized by the leakage of muscle cell contents¹. Acute kidney injury is a potential complication of severe rhabdomyolysis and carries a poor prognosis.

The common etiologies for rhabdomyolysis are trauma and direct compression but can also be due to non traumatic causes like seizures heat stroke and extreme exercise,drugs, toxins, infections, endocrinopathies, stings of insects and electrolyte disturbances-hypokalemia, hypocalciemia hypophosphatemia¹.

Though hypokalemia is very common medical problem, but it is rarely a cause of rhadomyolysis attributing to only 14-28% of cases². The mechanism of which is also not well understood.  Also, hypokalemia may go unrecognized in the case of rhabdomyolysis due to the release of potassium from damaged muscle into circulation. We present 2 cases of hypokalemia induced rhabdomyolysis.

Case 1

A 83 year old male presented with two days history of fever with vomiting for which he took antibiotics and later developed multiple episodes of loose stools following that. He developed slurring of speech and generalized weakness for  which he was admitted in a peripheral centre and after initial evaluation he was found to be hypokalemic with  a serum potassium of 1.8Meq/l. He was a known case of hypertension on regular medications .On admission at our centre he had an episode of vomiting  following which his airway was secured to prevent aspiration. He was hemodynamically unstable requiring vasopressor support.

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Ganesh K M

Senior Fellow Critical Care Medicine Fortis Hospital Bannerghatta Road