Aminoglutethimide-induced hyperkalaemia

Aminoglutethimide, a drug which inhibits adrenal hormone synthesis, may alleviate pain in metastatic breast carcinoma. A case is reported in which severe hyperkalaemia supervened two years after commencing treatment with aminoglutethimide; a constant dose was used in conjunction with cortisone supplements. This indicates the need for constant biochemical monitoring, or better still, prophylactic administration of fluorohydrocortisone as mineralocortical replacement. This is the first case of aminoglutethimide-induced hyperkalaemia reported, illustrating the rarity of the complication. Adrenal failure due to glucocorticoid deficiency was also present and required an increased dosage of cortisone. Maintenance of glucocorticoid and mineralcorticoid need regular review throughout therapy, to counteract intercurrent stress.