Finsterer J, Hess B, Jarius C, Stöllberger C, Budka H, Mamoli B
Ludwig Boltzmann Institute for Epilepsy and Neuromuscular Disorders, Vienna, Austria.
J Toxicol Clin Toxicol. 1998;36(4):369-73. doi: 10.3109/15563659809028035.
A 42-year-old man with a history of Billroth II-gastrectomy, chronic alcoholism, and malnutrition developed acute tetraparesis, two days before admission. He presented with bilateral, proximal upper and lower limb weakness, limb girdle wasting, bilaterally reduced Achilles tendon reflexes, and bilateral stocking-type sensory disturbances. Laboratory data revealed hypokalemia (2.2 mmol/L), elevated creatine 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 degeneration, interpreted as hypokalemic myopathy. With the correction of the serum potassium, tetraparesis rapidly resolved. With other causes excluded, malnutrition and gastrectomy were considered responsible for hypokalemia in this patient with acute tetraparesis and chronic alcoholism.
一名42岁男性，有毕Ⅱ式胃切除术、慢性酒精中毒和营养不良病史，入院前两天出现急性四肢轻瘫。他表现为双侧近端上肢和下肢无力、肢体带肌萎缩、双侧跟腱反射减弱以及双侧袜套样感觉障碍。实验室检查结果显示低钾血症（2.2 mmol/L）、肌酸激酶升高（7282 U/L）、代谢性碱中毒以及尿钾、白蛋白和总蛋白降低。肌肉活检显示有萎缩、坏死和再生的肌纤维、肌内膜巨噬细胞以及空泡变性，诊断为低钾性肌病。随着血清钾的纠正，四肢轻瘫迅速缓解。排除其他病因后，营养不良和胃切除术被认为是该急性四肢轻瘫合并慢性酒精中毒患者低钾血症的病因。
