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Life-threatening hyperkalemia from cream of tartar ingestion.

Journal of medical toxicology : official journal of the American College of Medical Toxicology (2012-08-29)
Daniel E Rusyniak, Pamela J Durant, James B Mowry, Jo A Johnson, Jayne A Sanftleben, Joanne M Smith
ABSTRACT

Cream of tartar (potassium bitartrate) has a long history as a cooking aid and medicinal purgative. Despite containing large amounts of potassium, there are no well-documented cases of it causing toxicity. We report two cases in which intentional ingestions of cream of tartar resulted in life-threatening hyperkalemia. In addition, we briefly review the use of cream of tartar as a historical purgative. In both cases, individuals ingested a large quantity of cream of tartar in an effort to "clean themselves out". They manifested similar initial symptoms (vomiting), abnormal serum potassium (>8.0 mmol/L), and EKG's with peaked T waves. Both patients were treated for hyperkalemia and recovered without complication. A search for articles on an academic internet database failed to identify any cases specifically dealing with ill effects of potassium bitartrate and numerous websites continue to purport its beneficial health effects. Ingestion of cream of tartar can potentially result in life-threatening hyperkalemia.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
DL-Tartaric acid, ReagentPlus®, 99%
Supelco
L-(+)-Tartaric acid, certified reference material, TraceCERT®, Manufactured by: Sigma-Aldrich Production GmbH, Switzerland
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D-(−)-Tartaric acid, puriss., unnatural form, ≥99.0% (T)
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L-(+)-Tartaric acid, ACS reagent, ≥99.5%
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L-(+)-Tartaric acid, ≥99.7%, FCC, FG
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D-(−)-Tartaric acid, ReagentPlus®, 99%
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L-(+)-Tartaric acid, ≥99.5%
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L-(+)-Tartaric acid, puriss., meets analytical specification of Ph. Eur., NF, 99.7-100.5% (calc. to the dried substance), powder
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L-(+)-Tartaric acid, BioXtra
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L-(+)-Tartaric acid, puriss. p.a., reag. ISO, 99.5-101.0% (calc. to the dried substance)
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L-(+)-Tartaric acid, anhydrous, free-flowing, Redi-Dri, ACS reagent, ≥99.5%