A Case of Toluene-induced Renal Tubular Acidosis Presented with Hypokalemic Paralysis

ABSTRACT

Toluene is known to cause a moderate degree of hypokalemia, myalgia, and even muscular weakness. We encountered the patient with acute hypokalemic paralysis in a chronic glue sniffer. A 32-year-old Korean male was taken to the emergency room with muscle weakness and somnolence. His serum chemistries showed severe hypokalemia and hyperchloremic metabolic acidosis. The urine toxicology screening showed excess levels of hippuric acid. His serum potassium level and metabolic acidosis were corrected after interruption of the offending agents and KCl & bicarbonate replacement. We report a case of severe hypokalemic muscular paralysis with renal tubular acidosis resulting from toluene inhalation.