Gas repellents herbal drugs could induce hyperkalemia in infants:  case series in tertiary centers in Saudi Arabia

Abdulrahman Alzahrani; Lama Alfakhri; Muteb Almutairi; Bander Alenaze; Faraj F. Al Harbi; Esam Barnawi

doi:10.18203/2349-3291.ijcp20242259

Authors

Abdulrahman Alzahrani Department of Pediatric Emergency, Emergency Administration, King Fahad Medical City, Second Health Cluster, Riyadh, Saudi Arabia; Department of Pediatric Emergency, Saudi Commission for Health Specialties (SCFHS), Riyadh, Saudi Arabia
Lama Alfakhri Department of Pediatric Emergency, Saudi Commission for Health Specialties (SCFHS), Riyadh, Saudi Arabia; Department of Pediatric Emergency, King Saud University Medical City, Riyadh, Saudi Arabia
Muteb Almutairi Department of Emergency Medicine, Saudi Commission For Health Specialties (SCFHS), Riyadh, Saudi Arabia; Department of Adult Emergency, Emergency Administration, King Fahad Medical City, Second Health Cluster, Riyadh, Saudi Arabia
Bander Alenaze Department of Pediatric Emergency, King Abdullah Specialized Children’s Hospital (KASCH). Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
Faraj F. Al Harbi Department of Pediatric Emergency, Emergency Administration, King Fahad Medical City, Second Health Cluster, Riyadh, Saudi Arabia
Esam Barnawi Department of Pediatric Emergency, Emergency Administration, King Fahad Medical City, Second Health Cluster, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2349-3291.ijcp20242259

Keywords:

Gas repellent, Potassium sorbate, Hyperkalemia, Infant, Herbal drug

Abstract

This is a case series involving four infants who experienced hyperkalemia (high levels of potassium in the blood) after using herbal gas repellents that contained potassium sorbate as an antimicrobial preservative. The first patient was a ten-day-old male who presented with jaundice and incidental hyperkalemia, which resolved with treatment. The second patient was a three-month-old male who had a history of neonatal critical care admission and presented with vomiting and incidental hyperkalemia, which resolved spontaneously. The third patient was a two-month-old female who presented with failure to thrive and incidental hyperkalemia, which resolved after discontinuation of the herbal gas repellent. The fourth patient was a one-month-old male who presented with vomiting and incidental hyperkalemia, which also resolved after discontinuation of the herbal gas repellent. All patients underwent investigations to determine the underlying cause of hyperkalemia, but no specific cause was found other than the use of the herbal gas repellents. The abstract highlights the importance of physicians being aware of the potential effects of potassium-containing herbal gas repellents and the occurrence of unexplained hyperkalemia in infants, urging caution in their use.

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References

Rossignol P, Legrand M, Kosiborod M, Hollenberg SM, Peacock WF, Emmett M, et al. Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future. Pharmacol Res. 2016;113(Pt A):585-91.

Katerji A, Trefi S, Bitar Y, Ibrahim A. Evaluation of new formulations for neutralizing antimicrobial preservatives in pharmaceutical preparations. Heliyon. 2023;9(3):e14555.

Awaad SS, Sherief MA, Mousa SM, Orabi A, Abdel-Salam AB. A comparative study on the antifungal effect of potassium sorbate, chitosan, and nano-chitosan against Rhodotorula mucilaginosa and Candida albicans in skim milk acid-coagulated (Karish) cheese. Vet World. 2023;16(9):1991-2001.

Martínez-Pineda M, Vercet A, Yagüe-Ruiz C. Are Food Additives a Really Problematic Hidden Source of Potassium for Chronic Kidney Disease Patients? Nutrients. 2021;13(10):3569.

Alfaifi JA, Alqarni SAM, Alqarni A, Alqahtani MM, Alshomrani RA. Parents' Knowledge, Attitude, and Practice Regarding Traditional Medicine on Their Children: A Community-Based Cross-Sectional Study in Bisha City, Saudi Arabia. Cureus. 2023;15(8):e43136.

Malhotra SK. Caraway. In: Peter KV, eds. Handbook of Herbs and Spices (Second Edition). Woodhead Publishing. 2012;225-48.

Taghavi F, Moosavi-Movahedi AA, Bohlooli M, Hadi Alijanvand H, Salami M, Maghami P, et al. Potassium sorbate as an AGE activator for human serum albumin in the presence and absence of glucose. Int J Biol Macromol. 2013;62:146-54.

Cupisti A, Kovesdy CP, D'Alessandro C, Kalantar-Zadeh K. Dietary Approach to Recurrent or Chronic Hyperkalaemia in Patients with Decreased Kidney Function. Nutrients. 2018;10(3):261.

Picard K, Picard C, Mager DR, Richard C. Potassium content of the American food supply and implications for the management of hyperkalemia in dialysis: An analysis of the Branded Product Database. Semin Dial. 2021;37(4):307-16.