Giant negative T waves in an elder with generalized pain and weakness

A 72-year-old man with a history of hypertension and chronic kidney disease presented to our emergency department complaining of numbness in his arms and legs, diarrhea, generalized pain, and weakness for 10 days, which gradually worsened and made moving difficult. His medications included trichloromethiazide, azosemide, doxazosin, nifedipine, carvedilol, and cilostazol. Additionally, prednisone had been used to treat cholesterol embolisms in the toes. Approximately 1 month prior, osteoporosis due to chronic kidney disease and steroid use was suspected, and denosumab therapy and calcium replacement ware initiated.