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REPORTof tachypnea, tachycardia, and severe acidosis, he was shifted to intensive care unit.Tropical fever, urinary tract infection, and other blood infections were ruled out with blood and urine investigations aided by imaging.Close monitoring of electrolytes and renal functions was done.Hyperkalemia required repeated treatment with intravenous insulin and dextrose.Despite no acute electrocardiogram (ECG) changes, calcium gluconate was administered for cardiostabilization.Patient gave history that these symptoms appeared after he was started on dapagliflozin a few days back in view of high blood sugars in spite old medications.Further workup showed highly elevated serum creatinine phosphokinase (CPK = 10980 U/L) and elevated urine myoglobin (>1200 ng/mL).However, despite optimal resuscitation, he was initiated on renal replacement therapy in view of worsening metabolic acidosis and acute renal failure on day 1 of admission.Thyroid profile showed thyroid stimulating hormone (TSH) of 9.597 µIU/mL.Renal functions and acidosis, though improved initially with two sessions of hemodialysis, again had gradual worsening requiring few more sessions of hemodialysis.To ascertain the
Nikhil et al. (Thu,) studied this question.