RECURRENT HYPOKALEMIC MUSCLE WEAKNESS AS AN INITIAL MANIFESTATION OF WILSONS-DISEASE

A 24-year-old man had several episodes of hypokalemic muscle weakness of undetermined etiology since the age of 13 years. Wilson's disease ( WD) was not diagnosed until the age of 18 when wing-beating tremor in the left upper limb was noted. Renal function study revealed incomplet e proximal renal tubular acidosis. The hypokalemic muscle weakness and wing-beating tremor had subsided after long-term penicillamine therap y. The present case indicates that recurrent hypokalemic paralysis due to renal tubular acidosis is a rare initial presentation of WD and ma y respond to penicillamine therapy.