Rhabdomyolysis as first presentation of the Conn’s syndrome: a clinical case

Abstract

Primary hyperaldosteronism is the leading cause of secondary hypertension, often presented with hypokalemia and even rare with its consequences. We describe a case of a 62-year-old man admitted to the emergency department with rhabdomyolysis from severe hypokalemia. Hypertension with hypokalemia and metabolic alkalosis should bring to the doctor’s attention the possibility of primary aldosteronism, which should also be confirmed by elevated plasma aldosterone concentration, a decreased plasma rennin levels, and high aldosterone/rennin ratio. The diagnosis of primary hyperaldosteronism was confirmed by an abdominal computed tomography, which revealed a solid mass at the posterior crus of the left adrenal gland. After the treatment of hypokalemia, neuromuscular symptoms regressed. Blood pressure and potassium levels normalized after laparoscopic adrenalectomy were performed. This rare clinical case highlights the diversity of the clinical presentation of primary hyperaldosteronism and emphasizes the need to be alert to the possibility of the presence of primary hyperaldosteronism in a patient who presents with hypertension and rhabdomyolysis induced by severe hypokalemia.

Keywords

• rhabdomyolysis
• hypokalemia
• metabolic alkalosis
• Conn’s syndrome