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Ventricular tachycardia developed at 24 hours of life with a serum potassium of 7.2 mmol\/L and hyperkalaemia medication treatment resulted in the resolution of the arrhythmia. At 42 hours of life, arrhythmia reoccurred with a serum potassium of 8.8 mmol\/L. Treatment for hyperkalaemia was initiated without a return to normal sinus rhythm, thus rectal sodium polystyrene sulfonate was administered and electrocardiogram (EKG) normalised. This is the first reported case of hyperkalaemia in a neonate associated with maternal sulfasalazine use. Healthcare professionals should be aware of potential electrolyte alterations with sulfasalazine use during pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2024-262380","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T20:50:27Z","timestamp":1737319827000},"page":"e262380","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Management of haemolysis-induced hyperkalaemia in an extremely low birthweight infant exposed to maternal sulfasalazine"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2592-2357","authenticated-orcid":false,"given":"Sophia","family":"Rafferty","sequence":"first","affiliation":[{"name":"Pediatrcs, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy","family":"Walters Burkey","sequence":"additional","affiliation":[{"name":"Neonatology, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudha","family":"Das","sequence":"additional","affiliation":[{"name":"Neonatology, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Aziz","sequence":"additional","affiliation":[{"name":"Neonatology, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"2025082710540978000_18.1.e262380.1","article-title":"Interventions for non-oliguric hyperkalaemia in preterm neonates","volume":"2012","author":"Vemgal","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082710540978000_18.1.e262380.2","first-page":"314","article-title":"Glucose and insulin infusion versus kayexalate for the early treatment of non-oliguric hyperkalemia in very-low-birth-weight infants","volume":"40","author":"Hu","year":"1999","journal-title":"Acta Paediatr Taiwan"},{"key":"2025082710540978000_18.1.e262380.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6204.1553"},{"key":"2025082710540978000_18.1.e262380.4","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1080\/00016340500334810","article-title":"Fetal hemolytic anemia associated with maternal sulfasalazine therapy during pregnancy","volume":"85","author":"Bokstr\u00f6m","year":"2006","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025082710540978000_18.1.e262380.5","doi-asserted-by":"publisher","DOI":"10.3109\/00365528109182032"},{"key":"2025082710540978000_18.1.e262380.6","doi-asserted-by":"crossref","unstructured":"EK S , Rosenborg S . 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