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KMID : 0882420070730001008
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Korean Journal of Medicine
2007 Volume.73 No. 0 p.1008 ~ p.1011
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Severe hypokalemia and status epilepticus associated with theophylline toxicity
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Cho Hyun-Sup
Kim Dong-Wook
Lee Dong-Won
Jung Eun-Young
Chang Se-Ho
Park Dong-Jun
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Abstract
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Theophylline can induce severe metabolic complications, including hypokalemia, seizure and cardiac arrhythmias. However, clinicians can fail to identify this drug as the cause of these complications. We describe here a case for which the patient’s theophylline toxicity went unrecognized over a period of several days after the complications developed. An 84-year-old man who was without any previous history of seizure was admitted to our hospital because of two episodes of generalized tonic-clonic seizure. His initial potassium level was 1.64 mmol/L. The electroencephalogram showed frequent, single or sequential, sharp and slow waves of high amplitudes on the right fronto-polar area, which was compatible with focal seizure. With giving only 100 mmol of K+ replacement over the three days, the serum potassium level increased to 3.5 mmol/L. His generalized tonic clonic seizure was controlled by lorazepam and phenytoin. We obtained the history of theophylline medication from his son on the 5th hospital day. At that time, the serum theophylline level was 9.18 ug/mL.(Korean J Med 73:S1008-S1011, 2007)
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KEYWORD
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Theophylline, Hypokalemia, Seizure
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