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Volume 9 Issue 2 (February, 2021)

Case Reports

An Abstruse Case of Refractory Hypokalemia- A Cabalistic Diagnosis
Nithish M Bhandary, Shreyas Samaga

Every physician comes across several diagnostic challenges while managing cases with electrolyte imbalances. Abiraterone acetate is the chemotherapeutic agent used in the treatment of Castration-resistant prostate cancer (CRPC). We report a diagnostic challenge faced due to persistent hypokalemia in a patient with prostate cancer. An elderly male who is a known case of type 2 diabetes mellitus, Castration resistant carcinoma prostate, on chemotherapy was admitted with electrolyte imbalance, bilateral lower limb cellulitis and Acute kidney injury. Even after prompt treatment, his hypokalemia persisted. Upon further workup, he was diagnosed to have syndrome of apparent mineralocorticoid excess (SAME) and was treated and discharged with low dose steroids upon which his potassium was corrected to normal. Treatment of such cases with low dose prednisone lowers the ACTH levels and in turn, reduce the mineralocorticoid related complications like hypokalemia in mCRPC patients treated with Abiraterone acetate.

 
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