Life-Threatening Hypokalemic Quadriplegia in a Postoperative Patient

Acute hypokalemic paralysis is a reversible but potentially lethal clinical condition. We report a case, who developed rapid-onset quadriparesis in immediate postoperative period after undergoing right percutaneous nephrolithotomy for bilateral renal stones. On evaluation, she was found to have hypernatremic, hyperchloremic, hypokalemic acidosis. This severe hypokalemia-induced quadriparesis was precipitated by repeated furosemide injections, use of potassium-free fluid as maintenance, intracellular shift due to free water administration in this patient, who had pre-existing distal renal tubular acidosis.