MARKED HYPOKALEMIA IN PROLONGED DIARRHEA: POSSIBLE EFFECT ON HEART

Abstract

Remarkably low values for serum potassium were found in an infant with severe diarrhea. This unusual abnormality most likely reflected an extreme deficiency of intracellular potassium which developed because of prolonged diarrhea and maintenance on fluids containing only dextrose and water.1 In the following report, evidences of marked potassium deficiency are presented from the chemical as well as the clinical viewpoint. Case history An eight-month-old female infant was admitted to the Children's Hospital of the University of Texas School of Medicine on July 10, 1946, because of severe diarrhea which had persisted for one month. Early in the course of the illness there were 6-8 watery green mucous stools a day, but by the tenth day 18-20 green, watery, blood-streaked stools were passed daily. The child was admitted to a local hospital and during the next week was given 2000 Ml. of 5% dextrose in distilled water by hypodermoclysis and 500 Ml. of blood intravenously. At the end of this time her weight was about 6.6 kg. which represented a loss of approximately 30% of her body weight; inasmuch as her weight was stated to be 9.4 kg. before the onset of her illness. During the month's illness she had refused all solid food and had reportedly taken not over a pint of milk,although 1200-1500 Ml. (40-50 oz.) of tap water were taken by mouth daily. On admission, the weight was 6.6 kg., temperature 38.2°C., pulse 100 per min., respiration 24 per min., and head circumference 41.8 cm. The