Clinical Case of Primary Hyperaldosteronism With Neuromuscular Symptoms

Abstract

The problem of diagnosing primary hyperaldosteronism remains relevant. A rare manifestation of primary hyperaldosteronism is secondary hypokalemic myoplegia, which may be the initial manifestation and cause difficulties in diagnosing primary hyperaldosteronism. It is expedient to describe new cases of primary hyperaldosteronism with an analysis of clinical features, possible diagnostic errors and difficulties. A clinical case of a patient with hypokalemic myopathic syndrome is presented. The level of potassium, aldosterone, renin in blood plasma was studied, and the aldosterone-renin ratio was determined. Adrenal adenoma was con-firmed by multispiral computed tomography and histology. Clinical observation demonstrates differential diagnostic difficulties of primary hyperaldosteronism, which were associated with a variety of clinical manifestations, nonspecificity of symptoms, dependence on the presence of hypokalemia, and erroneous diagnoses in anamnesis. Attention is drawn to the longterm normocaliemic course of primary hyperaldosteronism with arterial hypertension, which was regarded as a hypertensive disease. Primary hyperaldosteronism was suspected when myopathic syndrome appeared and dominated the clinical picture of the disease. Primary hyperaldosteronism, determining the occurrence of secondary hypokalemic myoplegia, presents significant differential diagnostic difficulties and requires physicians to be aware of the features of the clinical manifestations of primary hyperaldosteronism, alertness to the adrenal tumor, adequate assessment of the clinical picture, the use of a modern complex of diagnostic tools, internosological diagnostics and a multidisciplinary approach to therapy.