Multiple Dyselectrolytemia in a Chronic Alcohol Abuser: A Case Report

Electrolyte disorders in alcohol-dependent patients can be due to a multitude of reasons. We discuss a patient with diabetes mellitus, seizure disorder, and alcoholism who presented with seizure episodes and vomiting following a binge alcohol intake. The evaluation showed life-threatening metabolic derangements that included hyponatremia, hypokalemia, hypomagnesemia, hypocalcemia, hypochloremia, hypophosphatemia with elevated blood glucose, and metabolic alkalosis with a normal anion gap. Subsequently, a detailed urinary analysis revealed a urinary loss of electrolytes. We emphasize that alcohol-induced tubular injury is a possibility when such a clinical presentation is seen in the emergency room. The complex interplay of various electrolytes in homeostasis posed a great challenge in the management of this patient. Our case reiterates this intricate electrolyte correction policy.