Hyperkalemia-induced acute flaccid paralysis: a case report

Martina D'Ercole, Leda Cipriani, Daniela Picciotto, Stefania Bianzina, Elisa Russo, Francesca Viazzi, Pasquale Esposito

Research output: Contribution to journalArticlepeer-review


Acute flaccid paralysis is a medical emergency that may be caused by primary neuro-muscular disorders, metabolic alterations, and iatrogenic effects. Severe hyperkalemia is also a potential cause, especially in elderly patients with impaired renal function. Early diagnosis is essential for appropriate management. Here, we report the case of a 78-year-old woman with hypertension and diabetes presenting to the emergency department because of pronounced asthenia, rapidly evolving in quadriparesis. Laboratory examinations showed severe hyperkalemia of 9.9 mmol/L, metabolic acidosis, kidney failure (creatinine 1.6 mg/dl), and hyperglycemia (501 mg/dl). The electrocardiography showed absent P-wave, widening QRS, and tall T-waves. The patient was immediately treated with medical therapy and a hemodialysis session, presenting a rapid resolution of electrocardiographic and neurological abnormalities. This case offers the opportunity to discuss the pathogenesis, the clinical presentation, and the management of hyperkalemia-induced acute flaccid paralysis.

Original languageEnglish
JournalGiornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia
Issue number2
Publication statusPublished - Apr 14 2021


  • acute flaccid paralysis
  • diabetes
  • hemodialysis
  • hyperkalemia

ASJC Scopus subject areas

  • Medicine(all)


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