TETANY AND RHABDOMYOLYSIS DUE TO SURREPTITIOUS FUROSEMIDE - IMPORTANCE OF MAGNESIUM SUPPLEMENTATION

Diuretics may induce hypokalemia, hypocalcemia and hypomagnesemia. Whi le severe hypokalemia may cause muscle weakness, severe hypomagnesemia is associated with muscle spasms and tetany which cannot be corrected by potassium and calcium supplementation alone (1,2). Surreptitious d iuretic ingestion has been described, mainly in women who are concerne d that they are obese or edematous. Symptomatic hypokalemia has been r eported in such patients (3-7) and in one case hypocalcemia was observ ed (8), but the effects of magnesium depletion were not noted in these patients.