A Case of Diabetes Mellitus with Myoglobinuria due to Hypokalaemia

DOI Web Site 4 Citations
  • Oimomi Munetada
    The Second Department of Internal Medicine, Kobe University School of Medicine
  • Ishihara Kazuhide
    The Second Department of Internal Medicine, Kobe University School of Medicine
  • Saeki Susumu
    The Second Department of Internal Medicine, Kobe University School of Medicine
  • Morita Souichiro
    The Second Department of Internal Medicine, Kobe University School of Medicine
  • Kusaka Takaaki
    The Second Department of Internal Medicine, Kobe University School of Medicine
  • Baba Shigeaki
    The Second Department of Internal Medicine, Kobe University School of Medicine

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Other Title
  • 低カリウム血症を伴いmyoglobinuriaをきたした糖尿病の1症例
  • テイ カリウム ケッショウ オ トモナイ myoglobinuria オ キタ

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Abstract

There have not been many reports on myoglobinuria in Japan. This is a report on a case of diabetes mellitus with myoglobinuria supposedly induced by hypopotassemia. Case report: A 60 yearold woman was found to be diabetic in 1973. Since then she had been controlled with doses of 2.5 mg glibenclamide, but the control had become ineffective about the end of June, 1976 and at the beginning of July she was admitted to hospital with a rapid lowering of the strength of the lower limbs and of muscular strength in general. At the time of admittance, she was fully concious but she could not move her legs herself and strong signs of dehydration were observed. Blood sugar was 710mg/dl, ketone bodies in the urine were negative, osmotic pressure in the blood was 375 mOsm/l. Also, in addition to dehydration, electrolytes were abnormal: Serum sodium was 184 mEq/l, potassium 1.9 mEq/l, and the electrocardiogram indicated low potassium. Serum CPK was 3260 wu/ml, and her urine was dark brown. In hospital, she was given treatment to regulate the electrolyte. When these returned to a normal state, she recovered her muscular strength and she could walk by herself on the 8th day in hospital. The results of various laboratory examinations denied primary aldosteronism. It was thought that myoglobinuria caused by poor acclimatization to the rapid weather changes at the start of the Rainy Season (a very unsettled season in Japan hot and humid with very heavy rain) resulted in poor control of the diabetes and caused dehydration and hypopotassemia.<BR>It may be suggested that a diabetic might suffer from myoglobinuria when he or she become dehydrated and also high show electrolyte derangement. More attention should therefore be paid to these aspects during future research.

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