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J Korean Soc Emerg Med > Volume 17(6); 2006 > Article
Journal of The Korean Society of Emergency Medicine 2006;17(6): 656-658.
A Case of Toluene-induced Renal Tubular Acidosis Presented with Hypokalemic Paralysis
Jae Jun Park, Hyun Chang, Jong Yul Jung, Se Jin Jung, Kyung Ho Song, Won Na Suh, Sung Wan Chun, Ho Yung Lee, Tae Hyun Yoo
1Division of Nephrology, Institute of Kidney Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. hyl@yumc.yonsei.ac.kr
2Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.
Toluene is known to cause a moderate degree of hypokalemia, myalgia, and even muscular weakness. We encountered the patient with acute hypokalemic paralysis in a chronic glue sniffer. A 32-year-old Korean male was taken to the emergency room with muscle weakness and somnolence. His serum chemistries showed severe hypokalemia and hyperchloremic metabolic acidosis. The urine toxicology screening showed excess levels of hippuric acid. His serum potassium level and metabolic acidosis were corrected after interruption of the offending agents and KCl & bicarbonate replacement. We report a case of severe hypokalemic muscular paralysis with renal tubular acidosis resulting from toluene inhalation.
Key words: Toluene, Renal tubular acidosis, Hypokalemia
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