Une hypokaliémie symptomatique induite par une consommation excessive de Coca-Cola zéro®

Abstract

IntroductionCoca-Cola zero® is a caffeinated soft drink involved in cardiovascular risk factors, but did you know that it can be responsible for serious metabolic disorder? Case reportA 54-years-old patient presents a progressive asthenia with tetraparesis and neuropathic pain in upper and lower limbs. Laboratory tests showed severe hypokalemia (1.26mmol/L) with electrocardiographics signs, associated to an uncompensated metabolic alkalosis, rhabdomyolysis (CPK: 80 N). The management in intensive care unit allowed normalization of metabolic disorders without relapse when stopping supplements and she recovered motor deficit. Neuropathic pain persists and the electromyogram concluded to a length-dependent axonal sensitive polyneuropathy. The etiological assessment eliminated renal or extra-renal causes. She admitted a 2–5 liters per day Coca-Cola zero® potomania for more than ten years. DiscussionFew cases of symptomatic hypokalemia alcalosis due to excessive consumption of Coca-Cola® are described and various mechanisms have been implicated, linked to the components: caffeine, fructose, glucose. We report the first case severe hypokalemia-induced tetraparesis related to Coca-Cola zero®, sugar-free soda but containing sweeteners: this raises the question of the main toxicity of caffeine and the role of additives. ConclusionSymptomatic severe hypokalemic alkalosis induced by excessive consumption of Coca-Cola normal or zero® is an exclusion diagnosis that clinicians have to awred because of the complications which could be serious while the disorders could be reversible after supplementation and stopping intoxication. Additional research is needed on food components which can cause serious metabolic disorders in order to sensitize population with the danger of industrial junk food.