Fluctuating hypokalemia with late-onset hypomagnesemia and evolving acid–base disturbance: a case report

<title>Abstract</title> <p>I report a 20-year-old female with hypovolemic shock and profound hypokalemia (1.7 mmol/L). Initial labs mimicked distal renal tubular acidosis, but low urinary magnesium (1.2 mg/dL) confirmed gastrointestinal losses. Refractory potassium levels stabilized only after magnesium correction. This case highlights the importance of serial monitoring in complex electrolyte disturbances.</p>