Indomethacin-Induced Inhibition of Prostaglandin with Hyperkalemia

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To the editor: When the article by Tan and associates (1) appeared in the May 1979 issue, we had just seen a similar case.

An 82-year-old woman was receiving 25 mg of indomethacin four times a day and 10 grains of acetylsalicylic acid (aspirin) four times a day for rheumatoid arthritis. She had just developed an isoniazid polyneuritis and was on rifampicin-ethambutol therapy for active pulmonary tuberculosis. High blood pressure and edema secondary to indomethacin were controlled with furosemide, 40 mg daily. Renal function deterioration and hyperkalemia (highest value, 7.4 meq/L) resistant to sodium polystryrene sulfonate (Kayexalate; Winthrop Laboratories, New

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