• Am J Emerg Med · Nov 2019

    Case Reports

    Toluene toxicity presenting with hypokalemia, profound weakness and U waves in the electrocardiogram.

    • Edgar Francisco Carrizales-Sepúlveda, Raymundo Vera-Pineda, Raúl Alberto Jiménez-Castillo, Karla Belén Treviño-García, and Alejandro Ordaz-Farías.
    • Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico. Electronic address: edgar.carri_89@hotmail.com.
    • Am J Emerg Med. 2019 Nov 1; 37 (11): 2120.e1-2120.e3.

    AbstractWe present the case of a 25-year-old man with progressive limb weakness. His electrocardiogram showed prominent U waves which made us consider hypokalemia. The final diagnosis was toluene intoxication with severe hypokalemia and metabolic acidosis. Intravenous potassium administration and hydration effectively corrected the electrolyte and acid-base alterations; weakness resolved and the patient was discharged. The approach to a patient with acute weakness can be challenging. This case reminds us that the electrocardiogram can be a valuable tool in the evaluation and differential diagnosis of patients presenting to the emergency department with these conditions.Copyright © 2019 Elsevier Inc. All rights reserved.

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