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Shi P, Wang C, Lyu Y. Primary aldosteronism with hypokalemic rhabdomyolysis: a case report and review of the literature. J Med Case Rep 2024; 18:362. [PMID: 39118166 PMCID: PMC11313000 DOI: 10.1186/s13256-024-04708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/14/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Hypokalemic rhabdomyolysis is a rare clinical manifestation of primary aldosteronism, making its diagnosis challenging, particularly when it becomes the primary presenting symptom. Herein, we present a case of primary aldosteronism with hypokalemic rhabdomyolysis and conduct a related literature review. CASE PRESENTATION We report the case of a 54-year-old Chinese male patient who presented with intermittent weakness over the past year and was admitted with sudden limb paralysis for 2 days. The final diagnosis was primary aldosteronism accompanied by hypokalemic rhabdomyolysis syndrome. By reviewing the related Chinese and English literature, we noticed that only a few cases were published since 1978. After excluding irrelevant literatures, we summarized and analyzed 43 patients of with primary aldosteronism accompanied by hypokalemic rhabdomyolysis syndrome. All patients showed good recovery, with normalized blood potassium levels, and a majority achieved normalized blood pressure. Some patients still required medication for blood pressure control. CONCLUSIONS Primary aldosteronism rarely causes rhabdomyolysis; the occurrence of severe hypokalemia and rhabdomyolysis should prompt consideration of primary aldosteronism in the differential diagnosis. Early detection and treatment are crucial for determining patient prognosis.
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Affiliation(s)
- Pingan Shi
- Department of Endocrinology, Tianjin Hospital, 406 Jiefang South Road, Tianjin, 300210, China
- Department of Endocrinology, Tianjin Hospital of Tianjin University, Tianjin, China
| | - Chao Wang
- Department of Urology, Tianjin Hospital, Tianjin, China
| | - Yuanjun Lyu
- Department of Endocrinology, Tianjin Hospital, 406 Jiefang South Road, Tianjin, 300210, China.
- Department of Endocrinology, Tianjin Hospital of Tianjin University, Tianjin, China.
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Díaz-López EJ, Villar-Taibo R, Rodriguez-Carnero G, Fernandez-Pombo A, Garcia-Peino R, Blanco-Freire MN, Pena-Dubra A, Prado-Moraña T, Fernández-Xove I, Pérez-Béliz E, Cameselle-Teijeiro JM, Hermida-Ameijeiras A, Martinez-Olmos MA. Should we suspect primary aldosteronism in patients with hypokalaemic rhabdomyolysis? A systematic review. Front Endocrinol (Lausanne) 2023; 14:1257078. [PMID: 37810894 PMCID: PMC10558179 DOI: 10.3389/fendo.2023.1257078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
Severe hypokalaemia causing rhabdomyolysis (RML) in primary aldosteronism (PA) is a rare entity, and only a few cases have been reported over the last four decades. This systematic review and case report aims to gather all published data regarding a hypokalaemic RML as presentation of PA in order to contribute to the early diagnosis of this extremely rare presentation. With the use of PubMed Central, EMBASE, and Google Scholar, a thorough internet-based search of the literature was conducted to identify articles and cases with RML secondary to hypokalaemia due to PA between June 1976 and July 2023. The case study concerns a 68-year-old male patient with hypokalaemic RML at presentation of PA. In the systematic review of the literature, 37 cases of RML secondary to hypokalaemia due to PA have been reported to date. In summary, the median age was 47.5 years, the male/female ratio was 17/21, all patients presented symptoms (weakness and/or myalgia), all the patients were hypertensive, and only four patients had complications with acute kidney injury (AKI). Although PA rarely presents with RML, it should be suspected when marked hypokalaemia and hypertension are also present. Early detection and management are essential to reduce the frequency of manifestations such as AKI.
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Affiliation(s)
- Everardo Josué Díaz-López
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Unidad de Enfermedades Tiroideas e Metabólicas (UETeM)-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Health Research Institute of Santiago de Compostela (IDIS)-Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rocio Villar-Taibo
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gemma Rodriguez-Carnero
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Division of Epigenomics in Endocrinology and Nutrition Group-Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antia Fernandez-Pombo
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Unidad de Enfermedades Tiroideas e Metabólicas (UETeM)-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Health Research Institute of Santiago de Compostela (IDIS)-Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Roberto Garcia-Peino
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Alberto Pena-Dubra
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Teresa Prado-Moraña
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Unidad de Enfermedades Tiroideas e Metabólicas (UETeM)-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Health Research Institute of Santiago de Compostela (IDIS)-Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Irea- Fernández-Xove
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Edurne Pérez-Béliz
- Division of Pathology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose Manuel Cameselle-Teijeiro
- Division of Pathology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Medical Faculty, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alvaro Hermida-Ameijeiras
- Division of Internal Medicine, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel Angel Martinez-Olmos
- Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Molecular Endocrinology Group-Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
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Hypokalemia causing rhabdomyolysis in a patient with short bowel syndrome. J Emerg Med 2015; 48:e97-9. [PMID: 25680698 DOI: 10.1016/j.jemermed.2014.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 10/21/2014] [Accepted: 12/21/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Rhabdomyolysis, usually in the setting of trauma or drug use, is frequently seen in the emergency setting, and often leads to hyperkalemia at presentation. Hypokalemia, however, is a potentially underrecognized cause of rhabdomyolysis. CASE REPORT We present a case of rhabdomyolysis likely due to hypokalemia in the setting of short bowel syndrome. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although less common, hypokalemia can be a significant cause of rhabdomyolysis via its effects on muscle. This scenario should be considered in the differential diagnosis of patients at risk for hypokalemia who present with weakness. Rapid recognition of this relationship and rapid correction of hypokalemia may prove very important in preventing the deleterious effects of rhabdomyolysis.
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Yao B, Qin Z, Tan Y, He Y, Yan J, Liang Q, Xu W, Weng J. Rhabdomyolysis in Primary Aldosteronism: A Case Report and Review of the Literature. AACE Clin Case Rep 2015. [DOI: 10.4158/ep14277.cr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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