FRED H. KATZ, M.D., F.A.C.P.; ROSEMARIE C. ECKERT, M.D.; MICHAEL D. GEBOTT
A normotensive woman who had already undergone bilateral renal arteriography and renal vein catheterization for differential renin production was studied for her continuing hypokalemia. On the fourth day of a metabolic balance regimen she had a sudden diuresis, natriuresis, and kaliuresis. Urine analysis showed that she had surreptitiously taken at least 20 furosemide tablets, obtained from her employer, a pharmaceutical wholesaler. Psychiatric evaluation indicated underlying depression. A second patient, who was a nurse with a long-standing history of hypokalemia, had chlorthalidone, which she denied taking, detected in her urine. Another depressed woman with hypokalemia had furosemide in her urine more than 2 months after supposedly taking her last dose. Possible self-intoxication with diuretics to attain a slim figure should be considered in the differential diagnosis of obscure hypokalemia.
KATZ FH, ECKERT RC, GEBOTT MD. Hypokalemia Caused by Surreptitious Self-Administration of Diuretics. Ann Intern Med. ;76:85–90. doi: 10.7326/0003-4819-76-1-85
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Published: Ann Intern Med. 1972;76(1):85-90.
Endocrine and Metabolism, Fluid and Electrolyte Disorders, Nephrology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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