One report suggested that RTA could be transient in pregnant patients and that they recovered after delivery [6]

One report suggested that RTA could be transient in pregnant patients and that they recovered after delivery [6]. mediating the potassium-induced increase in muscular blood flow. The failure to release potassium during skeletal muscle contraction leads to diminished hyperemia, potentially resulting in muscle injury, ischemia, and necrosis. Potassium-depleted animals showed elevated creatine phosphokinase (CPK) activity in serum, suggesting a loss of skeletal muscle integrity [4]. This paper reports a case of a third-trimester healthy pregnant woman who presented with proximal muscle weakness, increased CPK, and severe hypokalemia. After recovery, she delivered a normal newborn. == 2 . Case Report == A 27-year-old woman, living in the central region of MC 70 HCl Thailand, gravida 1, presented at 37 weeks and 5 days’ gestation with complaints of both arm and leg weakness and painful muscle cramps. Her symptoms had begun 5 days earlier. She had myalgia and showed progressive difficulty of proximal muscle activities more than distal muscle activities, without signs of muscle wasting. The patient had no ptosis, and her respiration was MC 70 HCl normal. A dermatologic exam was unremarkable. She had no history of diarrhea or toxin exposure. Her daily medication consisted of a tablet of ferrous fumarate and a single supplement containing iron, iodine, and folic acid MC 70 HCl (Triferdine). She had no significant prior antenatal history, no hearing problem, no sign of autoimmune disease, no history of dry eyes or dry mouth, no history of diuretic intake, no history of chronic alcohol intake, and no family history of weakness and hypokalemia. In the initial assessment, the patient was afebrile, and her blood pressure was 109/65 mmHg. A neurological examination revealed the following motor power: grade 3/5 in both arms, grade 4/5 in both forearms, grade 4/5 in both thighs, and grade 5/5 in both legs. All the deep tendon reflexes were 2+. The well-being of the fetus was assured by a nonstress test. Normal fetal bone development and mineralization were observed by ultrasound. Investigations showed a total leukocyte count of 8, 310/mm3(500010000), with a neutrophil count of 68% (4075), a lymphocyte count of 24% (2050), a monocyte count of 6% (210), and eosinophil count of 2% (16). The hemoglobin was 11. 7 g (1115), platelets were 261, 000 cells/mm3(140, 000400, 000), serum potassium was 2 . 0 mmol/L (3. 55. 0), sodium was 139. 5 mmol/L (135145), and chloride was 108 mmol/L (97110). Bicarbonate was 19. 9 mmol/L (2232), and Mouse monoclonal to BLK it decreased over the next few days to 16. 0 mmol/L. In addition , albumin was 3. 2 g/dL (3. 45. 0), calcium was 9. 7 mg/dL (8. 410. 4), corrected serum calcium was 10. 34 mg/dL, magnesium was 1 . 8 mg/dL (1. 82. 4), phosphorus was 3. 8 mg/dL (2. 54. 5), blood sugar was 114 mg%, BUN was 4. 1 mg/dL (718), creatinine was 0. 52 mg/dL (0. 551. 02), aspartate aminotransferase (AST) was 194 U/L (1537), alanine aminotransferase (ALT) was 124 U/L (065), globulin was 2 . 7 g/dL (2. 83. 3), total bilirubin was 0. 43 g/dL (0. 010. 0), direct bilirubin was 0. 22 mg/dL (00. 50), and alkaline phosphatase was 137 U/L (40150). Urine analysis was negative for blood and urinary tract infections. The urinary pH was 7. 0 (5. 07. 5) on a pH meter, and the urinary ketone level was 2+. CPK was 5, 338 IU/L ( <145). Thyroid function tests were in the normal limit for a MC 70 HCl third-trimester pregnancy, and.