Primary Aldosteronism Associated with Severe Rhabdomyolysis Due to Profound Hypokalemia

Goto, Atsushi; Kishimoto, Mitsumasa; Minowada, Shigeru; Aibe, Hitoshi; Kanehiro, Hiromichi; Kajio, Hiroshi; Noda, Mitsuhiko

doi:10.2169/internalmedicine.48.1444

Cited by 34 publications

(21 citation statements)

References 31 publications

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“…Fourteen of the 15 cases detailed in our literature review involved chronic muscular symptoms, but none were given due attention or inspection. In one case, the condition was diagnosed as transient ischemic attack without measurement of serum electrolytes (1). In the present case, the patient was prescribed Table 2 Summary antihypertensive medications by his physician every 2 months for nearly 6 years, but the muscle symptoms were never considered.…”

Section: Discussionmentioning

confidence: 73%

“…As there was no consensus on the level of CPK for the diagnosis of rhabdomyolysis, we considered a level equal or greater than 1,500 U/L as the criterion. A total of 15 cases of PA complicated by hypokalemic rhabdomyolysis were identified (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Clinical features, diagnosis data, and treatment and outcomes of all cases are summarized in Table 2.…”

Section: Literature Reviewmentioning

confidence: 99%

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Rhabdomyolysis in Primary Aldosteronism: A Case Report and Review of the Literature

Yao

Qin

Tan

et al. 2015

AACE Clinical Case Reports

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Objective: Primary aldosteronism is one of the most common causes of secondary hepertension. We present here a case of primary aldosteronism in a 38-year-old Chinese male with a 6-year history of uncontrolled hypertension that evaded diagnosis until an attack of rhabdomyolysis due to profound hypokalemia. We also present the results of a comprehensive review of the current literature.Methods: We describe the presentation and symptoms of the patient and review the relevant literature. A thorough literature search disclosed 15 further cases of rhabdomyolysis due to undiagnosed primary aldosteronism reported between 1978 and 2013. We summarized the clinical features, treatments, and outcomes of those cases.Results: Many of the cases presented with previous hint of primary aldosteronism, yet they evaded diagnosis. Three of these patients developed acute renal failure. All patients survived, and many of them were restored to normal blood pressure and normal serum potassium levels after adrenal surgical interventions. Conclusion:Primary aldosteronism can lead to severe acute consequences of rhabdomyolysis via hypokalemia. It is important to alert physicians to the need for hyperaldosteronism workup when a rhabdomyolysis patient is found to be hypokalemic. (AACE Clinical Case Rep. 2015;1:e21-e27) Abbreviations: ARR = aldosterone to renin ratio; AVS = adrenal venous sampling; CPK = creatinine phosphokinase; CT = computed tomography; PA = primary aldosteronism; PAC = plasma aldosterone concentration; PRA = plasma renin activity

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Section: Discussionmentioning

confidence: 73%

Section: Literature Reviewmentioning

confidence: 99%

Rhabdomyolysis in Primary Aldosteronism: A Case Report and Review of the Literature

Yao

Qin

Tan

et al. 2015

AACE Clinical Case Reports

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“…Hypokalemia is an important cause of lesion in the skeletal muscle and rhabdomyolysis in humans, dogs and cats (SHELTON, 2005;GOTO et al, 2009). Moreover, potassium has an important mechanism in elevating the serum activity of CK in hypokalemic myopathy and in hyperaldosteronism (ROSE et al, 2007;SHELTON, 2005;NEMZEK et al, 1994).…”

Section: Resultsmentioning

confidence: 99%

Creatine kinase serum activity in feline hyperthyroidism

et al. 2014

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“…In special cases, severe skeletal muscle injury may be complicated and HM may occur (2,5,6). PA prominently characterized by HM is often misdiagnosed as PM in clinical practice because patients with PA who have severe skeletal muscle injury and significantly increased muscle enzyme levels are very rarely encountered by clinicians (2).…”

Section: Discussionmentioning

confidence: 99%

Hypokalemic myopathy in primary aldosteronism: A case report

Xin

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Primary aldosteronism (PA) is a rare disorder. The majority of patients with PA present with typical features and are easily diagnosed. This disorder is usually diagnosed with hypokalemia, hypertension or an adrenal mass. However, patients with atypical symptoms may present a challenge for diagnosis and treatment. In the present study, a case of PA is described that presented with hypokalemic myopathy simulating polymyositis. The patient was a 44-year-old woman who presented with weakness and difficulty walking. The patient was initially suspected to have PM and was treated with methylprednisolone. The patient was found to have hypokalemia which persisted despite high-dose supplementation of potassium. Adrenal computed tomography revealed a right adrenal mass. Surgical adrenalectomy was conducted. The final pathological diagnosis was benign adrenocortical adenoma. The serum tests remained normal and the patient's symptoms were resolved during the 8-month follow-up.

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Primary Aldosteronism Associated with Severe Rhabdomyolysis Due to Profound Hypokalemia

Abstract: A 55-year-old Japanese man was admitted to our hospital with severe weakness.

Cited by 34 publications

References 31 publications

Rhabdomyolysis in Primary Aldosteronism: A Case Report and Review of the Literature

Rhabdomyolysis in Primary Aldosteronism: A Case Report and Review of the Literature

Creatine kinase serum activity in feline hyperthyroidism

Hypokalemic myopathy in primary aldosteronism: A case report

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