Virginia Research Day 2025

Medical Student Research Case Reports

27 Chasing Highs but Getting Lows: A Case of Hypokalemia Associated with Cannabis Use

Christopher T. Gabbert; Fariha Bhuiyan; Terrance J. Truitt, MD Corresponding author: cgabbert@vt.vcom.edu

Edward Via College of Osteopathic Medicine - Virginia Campus

Hypokalemia is a relatively common reason for admission from the Emergency Department, with cannabis utilization being a more rare, indirect cause, as excessive use can lead to vomiting and diarrhea. However, more recent reports suggest further association with cannabis-induced hypokalemia, outside of GI losses. This case involves a 24-year old female with a history of anxiety, depression, and heavy cannabis use, who presented to the Emergency Department with generalized weakness and bilateral

medial leg pain for two days. She was found to have an initial potassium level of 1.8, which prompted immediate repletion and admission to the ICU. EKG showed QT prolongation and bradycardia. Her hospital stay was complicated with a low phosphorus level of 1.0 following fluid administration. Despite a comprehensive nephrological workup, no additional renal abnormalities, nor identifiable causes for the hypokalemia, were identified. The patient

was discharged with a potassium level of 4.0 with instructions for supplementation and to follow up with nephrology. This case further highlights the association of heavy cannabis use and electrolyte abnormalities alongside the need to include cannabis use in the differential diagnosis of unexplained hypokalemia.

*Written consent was obtained from the patient.

119 2025 Research Recognition Day