pica and Hypokalemia

We report a case of severe hypokalaemia and moderate hypophosphataemia from clay ingestion. A 60-year-old woman presented with flaccid paralysis. Investigations revealed a serum potassium level of 1.8 mmol/L, phosphate level of 0.56 mmol/L and creatine kinase level of 30 747 IU/L. She had marked proximal and distal muscle weakness due to severe hypokalaemia and concurrent hypophosphataemia, which likely contributed to the onset of rhabdomyolysis. The patient subsequently admitted to significant pica, most likely secondary to an associated iron deficiency. We conclude that the ingested clay acted as a potassium and phosphate binder. Although we did not investigate the content of the clay in this case, it has been reported that clay can bind potassium in vitro and is rich in minerals such as aluminium that could play a role in the binding of phosphate, although the exact mechanism remains unclear. The patient recovered fully and outpatient follow-up at 6 months and again at 40 months confirmed no electrolyte abnormality, myopathy nor any further geophagia.

Topics: Female; Humans; Hypokalemia; Hypophosphatemia; Middle Aged; Phosphates; Pica; Potassium

Pica is a commonly underappreciated disorder in pregnancy that can lead to several complications, including severe metabolic derangements and other adverse outcomes. We report a case of baking soda pica in pregnancy associated with both rhabdomyolysis and cardiomyopathy.. A multigravid woman at 37 weeks of gestation presented with weakness and severe hypokalemia. She subsequently had development of rhabdomyolysis and presumed peripartum cardiomyopathy. After delivery, it was discovered that the patient had a long history of consumption of large quantities of baking soda. Her condition improved with cessation of the pica.. Clinicians must have a high index of suspicion for pica in pregnancy because it can lead to complex diagnostic challenges and pregnancy complications. The diagnosis should be considered in a patient with unexplained metabolic abnormalities.

Topics: Adult; Cardiomyopathies; Female; Humans; Hypokalemia; Muscle Weakness; Pica; Pregnancy; Pregnancy Complications, Cardiovascular; Rhabdomyolysis; Sodium Bicarbonate

Topics: Adult; Aluminum Silicates; Botswana; Clay; Female; Humans; Hypokalemia; Muscular Diseases; Pica; Severity of Illness Index

We report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalemic metabolic alkalosis and rhabdomyolysis.. A multigravida at 31 weeks of gestation presented with weakness and muscle pain. She was found to have severe hypokalemic metabolic alkalosis and rhabdomyolysis, with elevation in serum transaminases and hypertension. We initially thought the patient had an atypical presentation of preeclampsia until it was realized that she was ingesting 1 full box of baking soda (454 g sodium bicarbonate) per day. Symptoms and abnormal laboratory findings resolved with discontinuation of the patient's pica practices.. Pica is a common but often overlooked practice that can potentially lead to life-threatening disorders. A thorough evaluation of a patient's dietary intake is extremely important, especially in the setting of atypical presentations of disease in pregnancy.

Topics: Adult; Alkalosis; Female; Humans; Hypokalemia; Pica; Pregnancy; Pregnancy Complications; Rhabdomyolysis; Sodium Bicarbonate

Topics: Adult; Female; Humans; Hypokalemia; Muscular Diseases; Pica; Pregnancy; Pregnancy Complications

Pica is an eating disorder associated with ingestion of variety of non-food substances. A postpartum patient who presented with acute flaccid quadriparesis was detected to have severe hypokalemia. After extensive investigations for cause of hypokalemia, history of geophagia (clay-eating) was obtained. Approach to hypokalemia and health hazards of pica are discussed.

Topics: Adult; Electrocardiography; Female; Humans; Hypokalemia; Pica; Quadriplegia

Topics: Anemia, Iron-Deficiency; Female; Humans; Hypokalemia; Intestinal Absorption; Iron; Paralysis; Pica; Potassium; Soil

Topics: Alum Compounds; Calcium Sulfate; Causality; Diagnosis, Differential; Electrolytes; Female; Humans; Hyperkalemia; Hypokalemia; Kidney Failure, Chronic; Middle Aged; Pica; Renal Dialysis; Sodium Bicarbonate; Starch

Topics: Adult; Africa; Female; Humans; Hypokalemia; Muscular Diseases; Pica; Soil

We present a case of severe hypokalemic myopathy during pregnancy caused by clay ingestion.. A multigravida presented with fatigue, muscle weakness, and a 3-day history of extremity pain. Serum potassium levels were 1.5 mEq/L, requiring intravenous potassium replacement. The initial evaluation was unrewarding for the cause of the patient's hypokalemia until a family member reported that the patient frequently ate large quantities of clay. Discontinuation of clay ingestion led to normalization of potassium levels.. Pica, the persistent ingestion of nonnutritive substances, can cause a number of medical problems. Pica of clay, called geophagia, can bind potassium in the intestine, leading to severe hypokalemic myopathy. Clinicians caring for pregnant women with fatigue, muscle weakness, and hypokalemia should consider geophagia as a possible cause.

Topics: Adult; Female; Humans; Hypokalemia; Muscular Diseases; Pica; Pregnancy; Pregnancy Complications

We have presented the case of a 43-year-old woman with severe myositis due to clay ingestion and hypokalemia. EMG studies revealed a pattern consistent with myositis, and muscle biopsy showed a nonspecific diffuse myositis. The clay was shown to act as a potassium binder. With potassium replacement and discontinuance of clay ingestion, the symptoms and signs abated and laboratory values returned to normal.

Topics: Adult; Aluminum Silicates; Clay; Electromyography; Female; Humans; Hypokalemia; Muscles; Myositis; Pica

Topics: Adsorption; Adult; Aluminum Silicates; Anemia, Hypochromic; Clay; Female; Humans; Hypokalemia; Pica; Potassium; Sodium

Topics: Anemia, Hypochromic; Female; Humans; Hypokalemia; Pica

Topics: Aluminum Silicates; Clay; Humans; Hypokalemia; Pica

Topics: Adolescent; Anemia; Anemia, Hypochromic; Cachexia; Drug Therapy; Feeding and Eating Disorders; Humans; Hypokalemia; Iron; Iron-Dextran Complex; Pica; Potassium; Social Conditions