• Obstetrics and gynecology · Feb 2006

    Case Reports

    Baking soda pica: a case of hypokalemic metabolic alkalosis and rhabdomyolysis in pregnancy.

    • Chad A Grotegut, Vani Dandolu, Sunita Katari, Valerie E Whiteman, Ossie Geifman-Holtzman, and Melissa Teitelman.
    • Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA. grotegca@tuhs.temple.edu
    • Obstet Gynecol. 2006 Feb 1; 107 (2 Pt 2): 484-6.

    BackgroundWe report a case of baking soda pica in a woman at 31 weeks of pregnancy causing severe hypokalemic metabolic alkalosis and rhabdomyolysis.CaseA multigravida at 31 weeks of gestation presented with weakness and muscle pain. She was found to have severe hypokalemic metabolic alkalosis and rhabdomyolysis, with elevation in serum transaminases and hypertension. We initially thought the patient had an atypical presentation of preeclampsia until it was realized that she was ingesting 1 full box of baking soda (454 g sodium bicarbonate) per day. Symptoms and abnormal laboratory findings resolved with discontinuation of the patient's pica practices.ConclusionPica is a common but often overlooked practice that can potentially lead to life-threatening disorders. A thorough evaluation of a patient's dietary intake is extremely important, especially in the setting of atypical presentations of disease in pregnancy.

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