Periodic paralysis: an uncommon complication of primary aldosteronism

Freitas, Ricardo Miguel Costa de; Moura, Alexandre Sampaio

doi:10.1590/s0004-27302003000600019

Cited by 1 publication

(2 citation statements)

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“…Primary hyperaldosteronism, also known as Conn’s syndrome, is the second most frequent endocrinopathy causing PP [ 5 ], when severe hypokalemia occurs, as in our case. This presentation is reported more frequently in East Asians and is very rare in Western countries [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The aldosterone-producing adrenal adenoma is the main cause of primary aldosteronism. Clinical manifestations include arterial hypertension, muscle weakness, headache, paresthesia, polydipsia, and polyuria [ 6 ]. The aldosterone to renin ratio is used to support the diagnosis (raised aldosterone levels with renin levels being normally low).…”

Section: Discussionmentioning

confidence: 99%

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Conn’s Syndrome: An Unusual Cause of Periodic Paralysis

Balhana¹,

Pina²,

Machete³

et al. 2022

Cureus

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Primary hyperaldosteronism, also known as Conn’s syndrome, is characterized by an independent and excessive aldosterone production in the adrenal cortex, causing hypernatremia, arterial hypertension, and, in some cases, potentially severe hypokalemia can occur. We report a case of a 45-year-old Caucasian woman, with a history of obesity and hypertension, who presented to the emergency room with a four-week evolution history of myalgia and ascending muscle weakness eventually resulting in tetraparesis. The initial blood analysis showed severe hypokalemia (1.5 mmol/L). Further laboratory studies revealed an elevated plasma aldosterone level with low renin activity, and thyroid function tests were consistent with mild primary hyperthyroidism. CT scan showed a nodular lesion in the left adrenal gland. A saline suppression test confirmed that aldosterone secretion and renin activity were not suppressed. Regression of tetraparesis was noted with vigorous potassium supplementation. A laparoscopic left adrenalectomy was performed, with consequent normalization of hypokalemia, without the need for supplementation. Periodic paralysis (PP) are a rare group of neuromuscular diseases that occur due to the affection of the ion channels of the skeletal muscle. Most cases are hereditary; nonetheless, secondary causes of PP have been reported in the literature. This case illustrates an unusual and severe presentation of primary hyperaldosteronism manifested by PP. The concomitant changes in thyroid function raised the possibility that we are facing the clinical influence of another rare entity: thyrotoxic hypokalemic PP. However, the resolution of hypokalemia after the removal of adrenal adenoma supported the major contribution of hyperaldosteronism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%