Case Presentation: A 61-year-old African American male with DMII and HTN, presented with intermittent muscle twitching, abdominal pain and fatigue of 2 weeks duration. Physical exam was notable for subtle myoclonic jerks and mild pitting edema of bilateral lower extremities. Lab work showed hemoglobin of 6.6 g/dl, potassium of 5.8 mEq/L and creatinine of 12.2 [...]