Hyperkalemic paralysis in primary adrenal insufficiency

Abstract

Hyperkalemic paralysis due to Addison's disease is rare, and potentially life-threatening entity presenting with flaccid motor weakness. This case under discussion highlights Hyperkalemic paralysis as initial symptomatic manifestation of primary adrenal insufficiency.

Hyperkalemic Periodic Paralysis Secondary to End-Stage Renal Disease and Excess Potato Consumption

“…Hyperkalemic periodic paralysis has been described in two forms: primary hyperkalemic periodic paralysis and secondary hyperkalemic periodic paralysis. Primary hyperkalemic paralysis (hyperkalemic periodic paralysis) is an inherited autosomal dominant disorder that impairs sodium channel function in skeletal muscle cells and thereby reduces the ability to regulate potassium levels [ 2 ]. Secondary hyperkalemic periodic paralysis is the acquired form of the disorder.…”

“…With secondary hyperkalemic periodic paralysis, neurophysiological testing has revealed that although there is normal muscle fiber activity, there is an interruption in nerve conduction rate within the skeletal muscle. Secondary hyperkalemic periodic paralysis is most commonly seen in patients with acute or chronic renal dysfunction, Addison’s disease, rhabdomyolysis, or excessive ingestion of potassium supplements or potassium-rich foods such as bananas or potatoes [ 2 ]. Our patient, unfortunately, had not received any dietary education since her diagnosis of ESRD six months prior and, as a result, continued to ingest large quantities of potatoes.…”

“…Hyperkalemic periodic paralysis can be acquired; it is commonly inherited genetically in the form of channelopathy. Secondary hyperkalemic periodic paralysis is seen less frequently and is attributed secondary to other disease processes or etiologies patients may be unaware of [ 2 ]. Obtaining a thorough medical history and recognizing electrocardiogram (ECG) findings of hyperkalemia are essential to identifying this neurologic manifestation so that treatment is not delayed.…”