Persistent Hyperkalemia Status Postadrenalectomy for Primary Aldosteronism

• Main Authors: Kristen A. Hyland, MD, Jennifer M. Perkins, MD
• Format: Article
• Language: English
• Published: Elsevier 2016-01-01
• Series: AACE Clinical Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S2376060520305873

ABSTRACT: Objective: To report a rare case of persistent hyperkalemia and suppressed renin-aldosterone axis after adrenalectomy for an aldosterone-producing adenoma.Methods: We present the laboratory results, radiologic and surgical findings, and clinical course and management of a patient who had surgery to treat primary aldosteronism induced hypertension.Results: A 43-year-old male presented with hypertension and hypokalemia, and was diagnosed with primary aldosteronism with an aldosterone-producing adenoma. Adrenalectomy after localization was followed by delayed development of hyperkalemia with suppression of aldosterone requiring long-term mineralocorticoid replacement.Conclusion: This case illustrates the rare occurrence of persistent mineralocorticoid deficiency after adrenalectomy in a patient with confirmed primary hyperaldosteronism.Abbreviations: MRA = mineralocorticoid receptor antagonist PRA = plasma renin activity