Atypical Presentation of Conn’s Syndrome
Faten Hadjkacem
Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
Khouloud Boujelben
Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
Houcine Bouchaala *
Department of Urology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Omar Kammoun
Department of Urology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Ibrahim Mejdoub
Department of Urology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Ayedi Lobna
Departement of Anatomopathology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Zghal Mouna
Departement of Anatomopathology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Mohamed Amine Mseddi
Department of Urology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Mourad Hadjslimen
Department of Urology, Habib Bourguiba Hospital, 3029 Sfax, Tunisia.
Mohamed Abid
Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
*Author to whom correspondence should be addressed.
Abstract
Primary Aldosteronism (PA) is a common cause of secondary hypertension, arising from aldosterone-producing adenomas.
It mostly presents with resistant hypertension, hypokalemia and metabolic alkalosis, secondary to excess secretion of aldosterone and a suppressed plasma renin activity (PRA).
Hypokalemia typically presents with myalgia, cramps and muscle weakness. Rhabdomyolysis associated with hypokalemia. Paralysis represent an uncommon presentation of PA, described in few cases in medical literature.
Herein, we report a 41-year-old male with an initial presentation of an acute onset paraplegia and malignant hypertension.
The biochemical evaluation revealed rhabdomyolysis potentially due to severe hypokalemia. Then, investigations for primary hyperaldosteronism showed an elevated aldosterone-renin ratio (ARR).
Preoperative localization study with contrast-enhanced computed tomography (CT) scan revealed a left adrenal adenoma.
Laparoscopic adrenalectomy resulted in a complete clinical resolution, normalization of kalemia, muscle enzymes and ARR.
Keywords: Hypokalemia, rhabdomyolysis, primary aldosteronism, adrenalectomy