Erosive Gastritis as a Trigger for Hypokalemic Paralysis in a Genetically Predisposed Patient

To the Editor, Hypokalemic paralysis is a rare neuromuscular emergency characterized by sudden, reversible muscle weakness due to low potassium levels in the blood. [1]Although hypokalemic paralysis due to gastrointestinal potassium loss is well-documented, the role of erosive gastritis as a trigger is seldom reported, especially in patients with a familial predisposition.We aim to emphasize this link based on a recent clinical case. [1 ,2] An 18-year-old female with type 1 diabetes mellitus experienced recurrent vomiting over 2 days, leading to a sudden onset of muscle weakness in her limbs and facial drooping.She had no history of diarrhea, kidney disease, or medication use.A family history of episodic electrolyte imbalances in a close relative suggested a genetic vulnerability.Upon examination, she was hemodynamically stable, with limb muscle strength rated 3/5-4/5.Laboratory test results showed severe hypokalemia (serum potassium 2.1 mEq/L) and electrocardiographic changes typical of hypokalemia, while her kidney function was normal.An upper gastrointestinal endoscopy revealed redness and erosions in the gastric body and antrum, indicative of erosive gastritis [Figure 1], and tests for Helicobacter pylori were negative.e patient was treated with intravenous and oral potassium supplements, antiemetics, and