{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:43:45Z","timestamp":1788381825503,"version":"build-2803163510"},"reference-count":18,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,4]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A70-year-old man, with established hypoadrenalism due to a previous bilateral adrenalectomy, was admitted with recurrent episodes of postural dizziness and presyncope. He had been discharged from hospital 3\u2009weeks earlier on a 1-month course of cotrimoxazole following a diagnosis of prostatitis. His electrolytes on admission showed new onset hyponatraemia and hyperkalaemia.<\/jats:p>\n               <jats:p>His usual glucocorticoid replacement dose was doubled in view of a presumed diagnosis of hypocortisolaemia. However, the hyperkalaemia persisted. On rereviewing his treatment, we suspected a possible diagnosis of cotrimoxazole-induced hyperkalaemia. Cotrimoxazole was stopped and ciprofloxacin started instead. His fludrocortisone replacement was doubled for 3\u2009days after stopping treatment to decrease his postural symptoms. His postural symptoms improved, his serum potassium decreased to normal levels and he was safely discharged.<\/jats:p>\n               <jats:p>It is essential to remember that cotrimoxazole, a commonly used antibiotic, can induce a potentially fatal hyperkalaemia especially in patients with known hypoadrenalism.<\/jats:p>","DOI":"10.1136\/bcr-2020-239543","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T13:33:02Z","timestamp":1614951182000},"page":"e239543","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Cotrimoxazole-induced hyperkalaemia in a patient with known hypoaldosteronism"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8676-4233","authenticated-orcid":false,"given":"Annalisa","family":"Montebello","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gruppetta","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"2025082708114261000_14.3.e239543.1","unstructured":"Byron May D . 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