Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
Am J Emerg Med. 2019 Nov;37(11):2120.e1-2120.e3. doi: 10.1016/j.ajem.2019.158417. Epub 2019 Aug 27.
We present the case of a 25-year-old man with progressive limb weakness. His electrocardiogram showed prominent U waves which made us consider hypokalemia. The final diagnosis was toluene intoxication with severe hypokalemia and metabolic acidosis. Intravenous potassium administration and hydration effectively corrected the electrolyte and acid-base alterations; weakness resolved and the patient was discharged. The approach to a patient with acute weakness can be challenging. This case reminds us that the electrocardiogram can be a valuable tool in the evaluation and differential diagnosis of patients presenting to the emergency department with these conditions.
我们报告了一例 25 岁男性，表现为进行性肢体无力。其心电图显示明显的 U 波，这使我们考虑低钾血症。最终诊断为甲苯中毒伴严重低钾血症和代谢性酸中毒。静脉补钾和补液有效地纠正了电解质和酸碱紊乱；肌无力得到缓解，患者出院。急性无力患者的处理可能具有挑战性。本病例提醒我们，心电图在评估和鉴别诊断急诊科出现这些症状的患者时是一种有价值的工具。
