[Hypokalemia, a key clinical data for diagnosing primary hyperaldosteronism]

Area of Science:

• Endocrinology
• Nephrology
• Cardiology

Background:

• Hypertension is a significant global health concern, often with secondary causes.
• Severe hypokalemia can be a critical indicator of underlying endocrine disorders.
• Primary hyperaldosteronism is a common cause of secondary hypertension.

Observation:

• A 37-year-old male presented with severe fatigue and lower limb weakness, alongside treated hypertension.
• Initial investigations revealed severe hypokalemia, suppressed plasma renin activity, and normal plasma aldosterone concentration.
• Abdominal CT identified a left adrenal mass, suggestive of a suprarrenal adenoma.

Findings:

• A salt loading suppression test confirmed primary hyperaldosteronism.
• Despite normal plasma aldosterone levels, 24-hour urinary aldosterone excretion was significantly elevated.
• Suppressed plasma renin activity persisted post-salt loading.

Implications:

• Adrenalectomy successfully treated the condition, leading to asymptomatic recovery.
• This case underscores the importance of investigating secondary causes of hypertension, even with normal aldosterone levels.
• Early diagnosis and surgical intervention can reverse the effects of primary hyperaldosteronism.