Natural liquorice‐induced pseudoaldosteronism causing severe hypokalaemia, hypertension and rhabdomyolysis

Angus, Lachlan; Stranks, Jessica L.

doi:10.1111/imj.14796

Cited by 1 publication

(1 citation statement)

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“…3 Hypokalemia-induced rhabdomyolysis is an underrecognized and poorly understood cause of rhabdomyolysis. In adults, a handful of these cases have been documented in association with primary aldosteronism, 11 diuretics and laxative abuse, 12,13 glycyrrhiza and natural licorice-induced pseudohyperaldosteronism, 14,15 and meropenem and budesonide therapies. 16,17 Even fewer cases of hypokalemia-induced rhabdomyolysis are reported in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

Hypokalemia-Induced Rhabdomyolysis in a Child with Autism Affected by the COVID-19 Pandemic

Cao

Gaffney

Marcus

2021

J Dev Behav Pediatr

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Objective:Pediatric patients with autism spectrum disorder (ASD) often have coexisting feeding disorders. We hope to emphasize the significant implications that these feeding disorders can have on this patient population through a unique case of hypokalemia-induced rhabdomyolysis.Method:We present a unique case of a 3-year-old boy with ASD and a longstanding history of food selectivity whose routine was disrupted during the COVID-19 pandemic resulting in avoidant/restrictive food intake disorder and severe undernutrition, who presented with profound hypokalemia and was subsequently found to have elevated muscle enzymes consistent with rhabdomyolysis despite only subtle complaints of difficulty walking.Results:The patient was treated with aggressive hydration, electrolyte therapy, and nasogastric tube feeds, which resulted in clinical and biochemical evidence of improvement. He was also reconnected to ASD-related care services that had lapsed during the COVID-19 pandemic.Conclusion:This case exemplifies the adverse impact that feeding disorders can have on patients with ASD, particularly in the setting of stressors such as a global pandemic, and is also the first documented pediatric case of rhabdomyolysis secondary to hypokalemia from severe undernutrition. It demonstrates that physicians should have a low threshold to assess for clinical and laboratory evidence of rhabdomyolysis in patients with profound hypokalemia because symptoms of hypokalemia-induced rhabdomyolysis can often be subtle, which can delay diagnosis and thereby increase the risk for life-threatening complications from extensive muscle damage.

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