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Case Reports
. 2025 Apr 11;17(4):e82069.
doi: 10.7759/cureus.82069. eCollection 2025 Apr.

A Rare Case of Primary Hyperaldosteronism Resulting in Severe Hypokalemia

Saad Sameer  1 , Aya J Qassim  1 , Ali Aqel  1 , Yousef H Al-Asa'd  1 , Shaefiq Babu Thappy  2
Affiliations
Case Reports

A Rare Case of Primary Hyperaldosteronism Resulting in Severe Hypokalemia

Saad Sameer et al. Cureus. .

Abstract

Hyperaldosteronism often clinically manifests as hypertension with mild to moderate hypokalemia. However, in rare cases, it can also present primarily with severe hypokalemia. In this case report, we will be discussing our patient, a 43-year-old woman who presented with abdominal cramps and vomiting, along with severe muscle cramps resulting in an inability to walk. She was found to have an undetectable level of serum potassium and prolonged QT interval on her ECG. After aggressive electrolyte correction and further imaging and endocrinology studies, she was diagnosed to have primary hyperaldosteronism. She was appropriately referred for urgent outpatient adrenalectomy, which turned out to be curative. Our case highlights the importance of timely diagnosis, interventions, and multidisciplinary care for patients with primary hyperaldosteronism.

Keywords: adrenal adenoma; endocrinology; hypokalemia related medical emergencies; multi-disciplinary care; nephrology; primary hyperaldosteronism; robotic adrenalectomy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Medical Research Center, Hamad Medical Corporation, Doha issued approval MRC-04-24-506, August 22, 2024. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. First ECG; prolonged QT interval of 520 ms.
Figure 2
Figure 2. Subsequent 12-lead ECG strip showing QTc of 500 ms.
QTc: corrected QT interval.
Figure 3
Figure 3. MRI abdomen depicting the right sided adrenal adenoma (circled in yellow), sized 2.5 x 2 cm in different planes. The lesion on the upper pole of the left kidney, sized 3.6 x 3.4 cm (circled in red) was later investigated and turned out to be an angiomyolipoma.
(A) Sagittal view, T2 weighted; (B) coronal view, T2 weighted; (C) axial view, T2 weighted; (D) coronal view, T1 weighted.
See this image and copyright information in PMC

References

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