{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T09:47:55Z","timestamp":1772272075805,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Hypokalemic periodic paralysis is a hereditary or acquired temporary flaccid paralysis of skeletal muscles, affecting proximal musculature more than distal, as a result of hypokalemia. In this report, we describe a unique case of amphetamine\u2010induced hypokalemic periodic paralysis that has only been described twice in the current literature. A 31\u2010year\u2010old male with a history of substance abuse presented with altered mental status and acute tetraparesis after inhalation of methamphetamine. Labs were significant for marked hypokalemia (1.8\u2009mmol\/L), elevated creatine kinase and a positive urine drug screen for methamphetamines. Aggressive potassium replacement was initiated, yet the patient remained hypokalemic, with worsening neurological status and aphasia. Intubation and mechanical ventilation became a necessity after the patient developed acute hypercapnic respiratory failure (pCO<jats:sub>2<\/jats:sub> 103\u2009mmHg, pH\u20097.02). Our patient then received potassium replacement via multiple routes, including intravenous and orogastric administration. After 15\u2009h, his potassium normalised, and he was successfully extubated the next day, regaining full motor strength. This case highlights the potential for amphetamine\u2010induced hypokalemic periodic paralysis to cause life\u2010threatening diaphragmatic paralysis and respiratory failure. How methamphetamine exactly induces hypokalemic periodic paralysis remains unclear, yet its indirect sympathomimetic effects with subsequent intracellular potassium shifts possibly explain the resultant hypokalemia. Given that methamphetamine use is on the rise, physicians should have a high index of suspicion for amphetamine\u2010induced hypokalemic periodic paralysis in patients presenting with acute paralysis and a substance use history. Rapid recognition, potassium repletion and respiratory monitoring are essential for patient recovery.<\/jats:p>","DOI":"10.1111\/nep.70056","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T08:59:16Z","timestamp":1747126756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Recognizing a Rare Presentation: Hypokalemic Periodic Paralysis Secondary to Amphetamine Use"],"prefix":"10.1111","volume":"30","author":[{"given":"Hamza","family":"Naveed","sequence":"first","affiliation":[{"name":"University of Houston\/HCA Houston Healthcare  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crystal","family":"Ike","sequence":"additional","affiliation":[{"name":"University of Houston\/HCA Houston Healthcare  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9198-9170","authenticated-orcid":false,"given":"Laith M.","family":"Haj\u2010Ahmad","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Jordan  Amman Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinidhi","family":"Shyamkumar","sequence":"additional","affiliation":[{"name":"University of Houston\/HCA Houston Healthcare  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damon","family":"Cao","sequence":"additional","affiliation":[{"name":"University of Houston\/HCA Houston Healthcare  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh639"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3892\/mi.2025.220"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/4678670"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26009"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.2588"},{"key":"e_1_2_8_7_1","unstructured":"H.Nesbitt American Society of Nephrology | Kidney Week \u2013 Abstract Details(2017) https:\/\/www.asn\u2010online.org\/education\/kidneyweek\/2017\/program\u2010abstract.aspx?controlId=2785751."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcl011"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2007.00963.x"},{"key":"e_1_2_8_10_1","volume-title":"GeneReviews\u00ae","author":"Weber F.","year":"1993"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1085\/jgp.202413610"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature05598"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1085\/jgp.202112946"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2013.04.004"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-014-2764-0"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2015.tb00630.x"},{"issue":"5","key":"e_1_2_8_17_1","first-page":"301","article-title":"The Need for Speed: An Update on Methamphetamine Addiction","volume":"31","author":"Barr A. M.","year":"2006","journal-title":"Journal of Psychiatry & Neuroscience"},{"key":"e_1_2_8_18_1","unstructured":"Consultant360 Marijuana\u2010Induced Hypokalemic Periodic Paralysis in a Teenager(2024) https:\/\/www.consultant360.com\/article\/consultant360\/marijuana\u2010induced\u2010hypokalemic\u2010periodic\u2010paralysis\u2010teenager."},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.73.1.92"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4598(200011)23:11<1773::AID-MUS17>3.0.CO;2-8"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T06:22:19Z","timestamp":1748240539000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/nep.70056"],"URL":"https:\/\/doi.org\/10.1111\/nep.70056","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2025-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70056"}}