2017, Number 6
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Med Int Mex 2017; 33 (6)
Rhabdomyolysis due to hypokalemia: an atypical manifestation of Conn’s syndrome
Martínez-Ruiz EE, Paz-Manifacio S, Sánchez-Díaz JS, González-De la Cruz E
Language: Spanish
References: 13
Page: 826-834
PDF size: 611.72 Kb.
ABSTRACT
Rhabdomyolysis is a condition with a broad spectrum of presentation
that can range from mild asymptomatic disease to fatal complications
due to electrolyte imbalance, arrhythmias and/or acute renal injury.
We report the case of a 35-year-old woman, hypertensive, who was
admitted for muscle weakness following a gastrointestinal condition.
Biochemically with severe hypokalemia, elevated creatinekinase,
conserved renal function, hypocalcemia and metabolic alkalosis.
Their comprehensive evaluation culminated in the diagnosis of
primary hyperaldosteronism secondary to an aldosterone-producing
adenoma which was surgically removed without complications. The
presentation of Conn’s syndrome with hypokalemia rhabdomyolysis
is exceptional since most cases are diagnosed with normokalemia or
mild hypokalemia from the secondary hypertension protocol. A high
level of suspicion and integral evaluation are necessary to arrive at
the correct diagnosis.
REFERENCES
Zimmerman JL, Shen MC. Rhabdomyolysis. Chest 2013;144(3):1058-1065.
Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: pathogenesis, diagnosis, and treatment. The Ochsner J 2015;15:58-69.
Bosch X, Poch E, Grau JM. Rhandomyolysis and acute kidney injury. N Engl J Med 2009;361:62-72.
Wen Z, Chuanwei Z, Chunyu Z, Hui H, Weimin L. Rhabdomyolysis presenting with severe hypokalemia in hypertensive patients: a case series. BMC Res Notes 2013;6:155.
Lee JH, Kim E, Chon S. Hypokalemia-induced rhabdomyolysis by primary aldosteronism coexistent with sporadic inclusion body myositis. Ann Rehabil Med 2015;39(5):826-832.
Funder JW, Carey RM, Mantero F, Murad MH, et. al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016;101(5):1889-1916.
Yao B, Qin Z, Tan Y, He Y, Yan J, Liang Q, et. al. Rhabdomyolysis in primary aldosteronism: a case report and review of literature. AACE Clinical Case Rep 2015;1:21-27.
Fainardi V, Cabassi A, Carano N, Rocco R, Fiaccadori E, Regolisti G, et. al. Severe hypokalemia and hypophosphatemia presenting with carpopedal spasm associated with rhabdomyolisis. Acta Biomed 2014;85(2): 167-170.
Kamath SD, Jain N, Rao BS. Triple electrolyte disorder (hypokalemia, hypophosphatemia and hypomagnesemia) a rare cause of rhabdomyolysis! SSRG-IJMS 2016;3(10):9- 13.
Lin SH, Yang SS, Chau T. A practical approach to genetic hypokalemia. Electrolyte Blood Press 2010;8:38-50.
Unwin RJ, Luft FC, Shirley DG. Pathophysiology and management of hypokalemia: a clinical perspective. Nat Rev Nephrol 2011;7:75-84.
Ferreire A, Bernal J, Hernández I, Molina M. Debilidad muscular en un paciente con hipertensión arterial sistémica. Revista de endocrinología y nutrición 2010;18(4):194-196.
Galati SJ. Primary aldosteronism, challenges in diagnosis and management. Endocrinol Metab Clin N Am 2015;44:355-369.