Hypokalemia and Quadriparesis

To the Editor —I read with interest the article by Orman et al¹ in the Archives. The authors state in the abstract of this case report that Yersinia enterocolitica-induced diarrhea should be added to the list of diseases causing severe hypokalemia; as though Y enterocolitica-induced diarrhea is particular in producing severe hypokalemia. The fact is that severe hypokalemia can be seen in any form of diarrhea that is associated with prolonged and significant volume and electrolyte losses. In severe diarrheal states, stool potassium loss could reach 100 mEq/d. This could amount to the loss of several hundred milliequivalents of potassium from the body in just a few days. Inadequacy of dietary intake is also a contributing factor in many of these cases. Fortunately, stool potassium loss does not parallel sodium loss as stool volume increases. Acidosis would mask the severity of potassium depletion, and alkalosis will potentiate