SHM Converge Scientific Abstract ePoster Gallery-Unique Mechanism of Hypokalemia in Elderly With Duchenne Muscular Dystrophy

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This case describes a 62-year-old man with Duchenne muscular dystrophy (DMD) who presented with fever and constipation and was found to have colitis and severe hypokalemia, with ECG U waves. He required aggressive potassium replacement, receiving 500 mEq over 9 hours, after which his potassium normalized and stayed stable during treatment with ceftriaxone and metronidazole.<br /><br />The key teaching point is that hypokalemia can be common and clinically significant in patients with DMD, especially during acute illness. The mechanism is not just poor intake or temporary loss: patients with DMD have reduced total-body potassium stores because normal potassium-rich muscle tissue is progressively replaced by collagen and other non-contractile tissue. As a result, they have much less potassium reserve and can become profoundly hypokalemic with relatively mild stressors such as infection, gastrointestinal illness, constipation, or other acute insults.<br /><br />Because their total potassium pool is low, repletion may correct potassium rapidly once replacement is started, so careful monitoring is important to avoid overcorrection. The case also highlights that DMD patients may live much longer than expected due to advances in care; this patient was the first recorded to live into his seventh decade. As longevity improves in pediatric and genetic diseases, clinicians must better understand chronic complications, including electrolyte vulnerability in adult patients with DMD.

Asset Subtitle

Soo-Hyun Lee

Meta Tag

Author List Maxwell Bressman MD, Soo-Hyun Lee

Category Clinical Vignettes

Concept Hypokalemia

Concept Duchenne Muscular Dystrophy

Concept Total Body Potassium

Concept Potassium Stores

Concept Severe Hypokalemia

Distinguished Non-Finalist

Presenter Organization Greenwich Hospital Residency Program

Presenting Author Soo-Hyun Lee

Track Adult

Keywords

Duchenne muscular dystrophy

hypokalemia

colitis

potassium replacement

ECG U waves

electrolyte imbalance

acute illness

total-body potassium stores

muscle tissue replacement

adult Duchenne muscular dystrophy

Hypokalemia

Duchenne Muscular Dystrophy

Total Body Potassium

Potassium Stores

Severe Hypokalemia