Hypokalemic Quadriparesis as the Initial Manifestation of Primary Aldosteronism: A Case Report
| Author | Mahdieh Emami | en |
| Author | Fatemeh Keshavarz | en |
| Author | Mahdieh Rouhi Adeshiri | en |
| Author | Sara Ghazizadeh | en |
| Author | Shahin Abbaszadeh | en |
| Orcid | Mahdieh Emami [0009-0007-8413-5648] | en |
| Orcid | Fatemeh Keshavarz [0000-0003-4898-7855] | en |
| Orcid | Mahdieh Rouhi Adeshiri [0009-0007-6603-7286] | en |
| Orcid | Sara Ghazizadeh [0000-0002-6849-8234] | en |
| Orcid | Shahin Abbaszadeh [0000-0003-0211-3829] | en |
| Issued Date | 2026-12-31 | en |
| Abstract | Introduction: Primary aldosteronism (PA) is estimated to affect approximately 5 - 10% of adults with hypertension. PA remains substantially underdiagnosed, with screening rates among adults with hypertension often below 1%. Case Presentation: A 50-year-old Gilak woman presented to our clinic with a history of severe hypertension for more than 10 years and recurrent episodes of acute quadriparesis. At presentation, she was receiving multiple antihypertensive agents. Initial examination revealed a hypertensive crisis, severe muscle weakness, profound hypokalemia, and a U wave on electrocardiography. We initiated immediate management of severe hypertension, discontinued hydrochlorothiazide, and started potassium supplementation. Measurement of serum renin and aldosterone levels showed an elevated aldosterone-to-renin ratio, raising suspicion for PA. Abdominal computed tomography identified a 2 × 1.5 cm enhancing left adrenal mass. The mass was surgically resected, and histopathology confirmed an aldosterone-producing adenoma. Conclusions: PA can rarely cause severe hypokalemia and quadriparesis. This case highlights the consequences of misdiagnosis and underscores the need for more stringent screening protocols for high-risk patients with hypertension or hypokalemia. | en |
| DOI | https://doi.org/10.69107/icrj-171753 | en |
| URI | https://brieflands.com/journals/ircrj/articles/171753 | en |
| Keyword | Hyperaldosteronism | en |
| Keyword | Primary Hyperaldosteronism | en |
| Keyword | Hypertension | en |
| Keyword | Secondary Hypertension | en |
| Keyword | Case Report | en |
| Publisher | Brieflands | en |
| Title | Hypokalemic Quadriparesis as the Initial Manifestation of Primary Aldosteronism: A Case Report | en |
| Type | Case Report | en |