Abstract
A 55-year-old man with a history of alcoholism was admitted to our hospital due to diabetic ketosis in May 2011. Chronic pancreatitis was diagnosed based on the patient's history, radiological findings on CT imaging and decreased exocrine function. His diabetes was attributed to pancreatic diabetes, and he was started on insulin therapy. Chronic diarrhea and body weight loss (7 kg within six months) began to develop in July 2012. He was subsequently referred to our hospital due to leg weakness associated with a marked hypokalemia (K 1.4 mEq/l) on December, 2012. The FEK (fractional excretion of potassium) and TTKG (trans-tubular potassium gradient) values were 2.15 % and 3.34, respectively. His serum potassium level normalized to 3.5 mEq/l by the second day of admission following the intravenous administration of potassium chloride. The total potassium dose of intravenous treatment was approximately 872 mEq. The patient's chronic diarrhea with steatorrhea was treated with a fat-restricted diet, pancreatic enzyme replacement and proton pump inhibitor. The marked hypokalemia was attributed to his low potassium intake associated with alcoholism and the intestinal loss of potassium due to chronic diarrhea. This case illustrates the necessity to monitor the electrolyte levels in the decompensated stage of chronic pancreatitis, as malabsorption due to an insufficient exocrine function associated with chronic diarrhea may result in serious complications.
