Gossypol related hypokalemia. Clinicopharmacologic studies.

In 1972, gossypol was shown to have a potent antifertility effect in man. Further clinical trials indicated that in certain districts such as Nanjing, occasional cases of hypokalemia or even hypokalemic paralysis may occur during gossypol administration. There were contradictory views concerning the etiology and pathogenesis of this condition. The authors carried out a series of clinicopharmacologic observations on gossypol related hypokalemic patients. The occurrence of hypokalemic paralysis is far more frequent in gossypol takers than in the control population which suggests that gossypol may be a causative agent in the disorder. In addition other factors such as low dietary potassium may contribute to the development of hypokalemia. In these patients, total body postassium is low and 1 of the apparent causes of body potassium depletion is renal potassium loss not due to hyperaldosteronism. The use of potassium salt at the stage of fatigability, a sure prodromal symptom of impending hypokalemic paralysis, is effective in the prevention of paralysis but for final resolution of the problem, the authors believe that increase in the dietary potassium level or even modification of the gossypol molecule may be necessary. Observation of the urine/serum potassium ratio in high water diuresis may be helpful to the diagnosis of normokalemic potassium deficiency.