# A 57-Year-Old Female Presenting With Cardiopulmonary Arrest Secondary to Severe Hypokalemia From a Fanconi-Like Syndrome: A Case Report

## TL;DR

A 57-year-old woman experienced a cardiac arrest due to severe potassium loss from a kidney disorder resembling Fanconi syndrome.

## Contribution

This case highlights the rare association between Fanconi-like syndrome and cardiopulmonary arrest due to severe hypokalemia.

## Key findings

- The patient had severe hypokalemia with evidence of proximal tubule dysfunction.
- Elevated urine potassium and other abnormalities pointed to a Fanconi-like syndrome as the underlying cause.
- The case underscores the importance of considering renal potassium wasting in cardiac arrest etiology.

## Abstract

Fanconi syndrome is a multi-factorial disorder that involves diffuse malfunction of the proximal convoluted tubule in the kidney. Renal wasting of potassium, glucose, bicarbonate, amino acids, and phosphorus characterize the condition. We report a case of a 57-year-old female who presented to our emergency department with cardiopulmonary arrest. After successful resuscitation, she had extensive workup to uncover the cause of her cardiac arrest. She had extensive negative workup but was found to have severely low potassium, prompting further evaluation. She was noted to have elevated urine potassium, with a trans-tubular potassium gradient of 9. She was also found to have severe glycosuria, hypophosphatemia, proteinuria, and an elevated urine anion gap, suggesting proximal convoluted tubular dysfunction. The hypokalemia noted on admission was thought to have been the causative factor for the cardiopulmonary arrest and was thought to be due to proximal tubule dysfunction, with the major suspected diagnosis being a Fanconi-like syndrome. This report highlights the diagnosis and treatment of hypokalemia, the broad differential involved with hypokalemia, and the syndromes involved with renal potassium wasting. This report also seeks to raise awareness of the association of renal potassium wasting with cardiopulmonary arrest.