Hypokalemic paralysis following intramuscular betamethasone injection: A case report and review of literature.

Autor: Ebrahimi P; Tehran Heart Center, Cardiovascular Disease Research Institute Tehran University of Medical Sciences Tehran Iran., Taheri H; Cedars-Sinai Cardiology Department Los Angeles California USA., Mousavinejad SA; Lorestan University of Medical Sciences Khorram Abad Lorestan Iran., Nazari P; Cancer Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran.
Jazyk: angličtina
Zdroj: Clinical case reports [Clin Case Rep] 2024 May 20; Vol. 12 (5), pp. e8923. Date of Electronic Publication: 2024 May 20 (Print Publication: 2024).
DOI: 10.1002/ccr3.8923
Abstrakt: Acute neuromuscular paralysis is a relatively common condition in emergency rooms (ERs). They can be caused by several reasons, including adverse drug reactions. Betamethasone is a glucocorticoid commonly used for various conditions, such as allergic conditions. One of the rare but known side effects of glucocorticoids is hypokalemia. Rare cases of hypokalemia following high- and low-dose glucocorticoid injections have been reported. This study presents the history of a young, healthy male without significant past medical history who presented with an inability to stand and walk due to four-limb paralysis (more prominent in the lower limbs) following an intramuscular injection of a 4 mg betamethasone, which was prescribed for the treatment of allergic rhinitis. The patient was stabilized with an intravascular injection of potassium chloride diluted in 1000 mL of normal saline and monitored for 24 h, ruling out any other endocrine condition. Hypokalemia and its severe form are defined as the serum level of lower than 3.5 and 2.5 mEq/Lit, respectively. One of the etiologies of drug-induced hypokalemic paralysis is systemic glucocorticoid administration. In severe cases, it can cause quadriplegia and other neuromuscular, respiratory, and cardiac complications. Therefore, it is an urgent condition that should be managed carefully. Pregnant women who are receiving these medications are a specific group at risk of hypokalemic paralysis. There are several safer treatments for seasonal allergic rhinitis compared to systemic glucocorticoids, which should be considered by physicians. Moreover, paralysis in patients receiving these medications should be approached attentively since it might be caused by hypokalemia, which can be life threatening if not treated. It is advisable that the blood level of electrolytes, especially potassium, be checked for patients who present with paralysis or weakness after glucocorticoid injections.
Competing Interests: The authors declare no conflicts of interest.
(© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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