{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:29Z","timestamp":1760145749399,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taoyuan Armed Forces General Hospital","award":["TYAFGH-D-113032"],"award-info":[{"award-number":["TYAFGH-D-113032"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Hypokalemic paralysis is a clinical syndrome characterized by acute flaccid paralysis with concomitant hypokalemia. Complications, such as acute respiratory failure and cardiac arrhythmias, can be fatal. If treated appropriately, the patient can recover without any sequelae. We present a rare case of life-threatening hypokalemic paralysis following the ingestion of an unknown substance. At presentation, her serum potassium concentration was 1.9 mmol\/L. A review of the patient\u2019s history confirmed the ingestion of barium chloride. She was diagnosed with acute barium poisoning characterized by high serum and urine barium levels. Aggressive potassium repletion was administered intravenously and orally. Her serum potassium concentration dropped to 1.5 mmol\/L and peaked at 5.4 mmol\/L following treatment. The patient achieved a complete recovery and was discharged without sequelae. Barium can competitively block the potassium inward rectifier channels and interfere with the efflux of intracellular potassium, leading to severe hypokalemia. Our report illustrates a rare presentation of acute barium intoxication and a differential diagnosis indicating hypokalemic paralysis. We also discuss the pathophysiological features and compare the clinical findings with cases of rebound hyperkalemia.<\/jats:p>","DOI":"10.3390\/reports7030072","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T11:54:10Z","timestamp":1724846050000},"page":"72","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Life-Threatening Hypokalemic Paralysis and Prevention of Severe Rebound Hyperkalemia in a Female with Barium Poisoning: A Rare Case Report"],"prefix":"10.3390","volume":"7","author":[{"given":"Ting-Wei","family":"Liao","sequence":"first","affiliation":[{"name":"Division of Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruei-Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szu-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6223-2478","authenticated-orcid":false,"given":"Ya-Chieh","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital Hsinchu Branch, Hsinchu 300, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Fang","family":"Chiang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Jen","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"},{"name":"Department of Life Sciences, National Central University, Taoyuan 320, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"key":"ref_1","first-page":"719","article-title":"Cardiac arrhythmias in primary hypokalemic periodic paralysis: Case report and literature review","volume":"8","author":"Sagray","year":"2022","journal-title":"Heart Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/j.jaccas.2021.05.013","article-title":"Ventricular Fibrillation: A Rare Initial Presentation of Thyrotoxic Periodic Paralysis","volume":"3","author":"Soneji","year":"2021","journal-title":"JACC Case Rep."},{"key":"ref_3","first-page":"e3921","article-title":"Clinical and Etiological Spectrum of Hypokalemic Periodic Paralysis in a Tertiary Care Hospital in Pakistan","volume":"11","author":"Sardar","year":"2019","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1258\/acb.2007.006080","article-title":"Hypokalaemic paralysis precipitated by distal renal tubular acidosis secondary to Sj\u00f6gren\u2019s syndrome","volume":"45","author":"Comer","year":"2008","journal-title":"Ann. 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