The article by Cabrera Serrano and Rabinstein provides interesting insight into the causes of acute neuromuscular respiratory failure.1 However, it is not clear why the authors have not investigated serum potassium levels. In acute neuromuscular respiratory failure, hypokalemia is an important cause to be ruled out.2 Certain disorders like Sjögren syndrome3 and renal tubular acidosis4 may manifest as acute neuromuscular respiratory failure due to hypokalemia. Many patients have associated precipitating causes like dehydration, infection, alcoholism, and glue sniffing. Hypokalemia may also lead to cardiac arrhythmia, along with respiratory failure. If identified early and treated, the prognosis is excellent and may be life saving.
Pandey S. Acute Neuromuscular Respiratory Failure. Arch Neurol. 2011;68(3):395-399. doi:10.1001/archneurol.2011.15a