A 41 year old man presented with global weakness. He was unable to extend his wrists past neutral and unable to move against resistance with any extremity. Turns out his potassium was 2.8 and his phosphorus was 0.6. When these were replaced, his exam was normal. But why were they this low? Especially as his hypertension was treated with an ACE inhibitor and triamterene.
We have a lot of Bartter's syndrome in East Tennessee, but these hypokalemic people are usually asymptomatic at 2.8.