Department of Endocrinology, Tianjin Hospital, 406 Jiefang South Road, Tianjin, 300210, China.
Department of Endocrinology, Tianjin Hospital of Tianjin University, Tianjin, China.
J Med Case Rep. 2024 Aug 9;18(1):362. doi: 10.1186/s13256-024-04708-8.
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.
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.
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.
低钾性横纹肌溶解症是原发性醛固酮增多症的一种罕见临床表现,使其诊断具有挑战性,特别是当它成为主要表现症状时。本文报道了 1 例低钾性横纹肌溶解症伴原发性醛固酮增多症的病例,并进行了相关文献复习。
我们报告了 1 例 54 岁的中国男性患者,其在过去 1 年中间歇性出现乏力,并因 2 天前突然出现四肢瘫痪而入院。最终诊断为低钾性横纹肌溶解症伴原发性醛固酮增多症。通过查阅相关的中、英文文献,我们注意到自 1978 年以来仅发表了少数几例。排除不相关文献后,我们对 43 例低钾性横纹肌溶解症伴原发性醛固酮增多症的患者进行了总结和分析。所有患者均恢复良好,血钾水平正常,大多数患者血压正常。部分患者仍需药物控制血压。
原发性醛固酮增多症很少引起横纹肌溶解症;严重低钾血症和横纹肌溶解症的发生应促使在鉴别诊断中考虑原发性醛固酮增多症。早期发现和治疗对确定患者的预后至关重要。