Ureterosygmoidostomy-associated quadriparesis, non-traumatic rhabdomyolysis, and tetany in an adult

Abstract

We report an adult case of ureterosigmoidostomy-associated quadriparesis, rhabdomyolysis, and tetany which may be the first such case in the literature. A 32-year-old female patient was brought to the emergency room of our hospital, having been unable to walk or use her arms for 24 h. Neurological examination revealed quadriparesis. She had severe hypokalemia (1.27 mmol/l) and metabolic acidosis (pH = 7.05). Creatine kinase value was 2,590 U/l on the third day. She received intensive therapy to correct the hypokalemia and acidosis. On the third day of hospitalization tetany was detected in her upper extremities. The patient regained full muscle power after intravenous potassium chloride, bicarbonate, and calcium replacement therapy.

Hypokalemia-associated paralysis and metabolic acidosis in a patient with bilateral ureterosigmoidostomy

“…Ureterosigmoidostomy is a surgical procedure in which the ureters are diverted into the sigmoid colon, although it often results in metabolic complications [1]. One of these complications is hypokalemia, which can cause muscular paralysis such as quadriparesis [2][3][4][5][6]. This diversion technique was previously performed in patients with invasive bladder cancer, bladder exstrophy, or urethral trauma.…”

Severe hyperkalemia following ureteroileostomy: A case report and literature review

“…[8] In the presence of urine in contact with the gut mucosa these factors may lead to dramatic diverse changes, depending upon the gut segment involved. Indeed, ureterosigmoidostomy has often been associated with hypokalemia, [10] which might be intensified by renal losses, mediated by protracted metabolic acidosis, [11] with effective volume depletion and activated renin-angiotensin-aldosterone axis. [12] By contrast, uretero-jejunostomy has been associated with hyperkalemia, presumably due to potassium reabsorption by the jejunal mucosa.…”

Complicaciones metabólicas y óseas de las derivaciones urinarias

“…Se han descrito otras alteraciones como hipopotasemia, hipomagnesemia, hipocalcemia, hiperamonemia y elevación de la creatinina y la urea en sangre. En la literatura hay comunicados casos aislados de parálisis muscular secundaria a acidosis hipopotasémica en relación con ureterosigmoidostomías [14][15][16] .…”