Conn's Syndrome with an Unusual Presentation of Rhabdomyolysis Secondary to Severe Hypokalemia

Tien-Hua Chuang ^a, Chih-Hsein Wang ^a, Bo-Yuan Tseng ^b, Yung-Hsiang Hsu ^b, Jen-Pi Tsai ^c, Bang-Gee Hsu ^{a, d}, Te-Chao Fang ^{a, d}

^aDivision of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^bDepartment of Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^cDivision of Nephrology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^dDepartment of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan

Download PDF

Abstract

Conn's syndrome is one of the major causes of secondary hypertension. Premature hypertension, metabolic alkalosis, and hypokalemia usually lead clinicians to suspect the diagnosis. We describe a case of Conn's syndrome in a 28-year-old woman with an unusual presentation of rhabdomyolysis secondary to hypokalemia and complete bilateral lower limb paralysis. An elevated transtubular potassium concentration gradient, asymptomatic severe hypertension, and metabolic alkalosis pointed to possible primary hyperaldosteronism, which was confirmed by a decrease in plasma renin activity (PRA), elevation in plasma aldosterone level and elevation of the plasma aldosterone to PRA ratio. Computed tomography showed an adrenal tumor in the adrenal gland. Her blood pressure, hypokalemia, and plasma aldosterone level returned to normal after left adrenalectomy, further confirming the diagnosis. Histologic examination showed an adrenal gland adenoma.

Keywords

Conn's syndrome; Hypokalemia; Rhabdomyolysis