A cola-induced hypokalemic rhabdomyolysis with electromyographic evaluation: A case report

Abstract

Objective:To report a rare case of hypokalemic rhabdomyolysis induced by the heavy and prolonged ingestion of cola-based beverages, and its uneventful recovery after kalemia normalization.Methods:We report a 38-year-old Caucasian male presented in our emergency room with a recent and progressive weakness of the lower limbs proximal muscles.Results:A dietary history revealed a prolonged ingestion of cola-based beverages. Blood tests showed severe hypokalemia and marked increase in serum creatine phosphokinase. The analysis of cerebrospinal fluid resulted normal. Electromyography was suggestive for a myopathy. The clinical, laboratory and neurophysiological data were evocative for a cola-induced hypokalemic rhabdomyolysis. After kalemia normalization, the improvements of the electromyographic findings paralleled the clinical recovery.Conclusion:Chronic consumption of large amount of cola-based soft drinks may result in severe symptomatic hypokalemia, eventually leading in turn to myopathy. To our knowledge, this is the first description of the electromyographic findings of the cola-induced hypokalemic rhabdomyolysis. An early diagnosis and a prompt treatment appear to be crucial for a benign clinical course.

Hipopotasemia asociado al consumo de bebidas cola

“…Datos similares fueron hallados en varios de los casos descritos en la literatura. (10)(11)(12)(13) La ingesta de grandes cantidades de glucosa es otro mecanismo por el cual se explica la hipopotasemia de nuestro paciente. La concentración de glucosa en las bebidas cola azucaradas es de 11 gr/dl.…”

Reversible Takotsubo Syndrome Complicated With Acute Thromboembolic Stroke Co-Occurring With Cola-Induced Severe Hypokalemia

“…Hypokalemia can result from decreased potassium intake, extracellular to intracellular shift, and uncompensated gastrointestinal or renal loss of serum potassium. There are multiple reports of cola-induced severe hypokalemia complicated with myopathy, rhabdomyolysis, acute kidney injury, and atrial fibrillation following the excessive consumption of those drinks [5][6][7][8]. The proposed mechanism of cola-induced hypokalemia was discussed by Tsimihodimos et al; they indicated that, when consumed excessively, the unabsorbed fructose content of cola soft drinks can cause osmotic diarrhea and subsequent gastrointestinal loss of potassium.…”