MALNUTRITION-INDUCED HYPOKALEMIC MYOPATHY IN CHRONIC-ALCOHOLISM

Case Report: A 42-year-old man with a history of Billroth II-gastrecto my, chronic alcoholism, and malnutrition developed acute tetraparesis, two days before admission. He presented with bilateral, proximal uppe r and lower limb weakness, Limb girdle wasting, bilaterally reduced Ac hilles tendon reflexes, and bilateral stocking-type sensory disturbanc es. Laboratory data revealed hypokalemia (2.2 mmol/L), elevated creati ne kinase (7282 U/L), metabolic alkalosis and reduced urine potassium, albumin, and total protein. Muscle biopsy showed atrophic, necrotic, and regenerating fibers, endomysial macrophages, and vacuolar degenera tion, interpreted as hypokalemic myopathy. With the correction of the serum potassium, tetraparesis rapidly resolved. With other causes excl uded, malnutrition and gastrectomy were considered responsible for hyp okalemia in this patient with acute tetraparesis and chronic alcoholis m.