Recurrent motor paralysis in a young patient with hypertension

作者：Adriana Albu, A. Nicu, Adela Pitforodeschi, M. Groza, Doinița Crișan · 发表于：Balneo and PRM Research Journal · 年份：2025 · DOI：10.12680/balneo.2025.940

We present a case of a young patient with severe myopathy and repeated episodes of lower limb paralysis. The patient was diagnosed as having primary hypertension and because of severely increased blood pressure he received four hypo-tensive drugs including a diuretic. Laboratory analyses indicated severe hypokalemia and increased creatin kinase. The association of resistant hypertension with hypokalemia suggested primary hyperaldosteronism (PA) confirmed by the increased values of aldosterone and suppression of renin. Abdominal computed tomography identified an adrenal ade-noma as being the cause of increased aldosterone concentration. Even though muscle weakness is frequently associated in PA, paralytic hypokalemic myopathy with rhabdomyolysis is a rare finding, imposing a differential diagnosis with other causes of myositis. In our patient, muscular symptoms have remitted after hypokalemia correction. Surgical re-moval of adrenal adenoma significantly reduced arterial pressure values and persistently normalized serum potassium. Conclusion. In patients with arterial hypertension, muscle weakness may be a sign of hypokalemic myopathy suggest-ing PA. The administration of diuretics in these patients may aggravate hypokalemia and its unfavorable clinical con-sequences including severe rhabdomyolysis.