Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic
Primary hyperaldosteronism (PA) usually presents with moderate to severe hypertension with or without hypokalemia in adults. However, PA is not commonly associated with severe hypomagnesemia. By contrast, Gitelman syndrome usually presents with clinical manifestations of hypokalemia and hypocalcemia...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2019-01-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/0886022X.2019.1662439 |
| _version_ | 1818734207218745344 |
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| author | Phatharaporn Kiatpanabhikul Wasakorn Bunyayothin |
| author_facet | Phatharaporn Kiatpanabhikul Wasakorn Bunyayothin |
| author_sort | Phatharaporn Kiatpanabhikul |
| collection | DOAJ |
| description | Primary hyperaldosteronism (PA) usually presents with moderate to severe hypertension with or without hypokalemia in adults. However, PA is not commonly associated with severe hypomagnesemia. By contrast, Gitelman syndrome usually presents with clinical manifestations of hypokalemia and hypocalcemia due to hypomagnesemia. Here, we present the case of a 44-year-old woman who first presented with peripheral paresthesia. Her laboratory tests revealed severe hypokalemia, metabolic alkalosis, severe hypomagnesemia, hypocalcemia and secondary hyperparathyroidism. The patient took high dose KCL tablets and Mg tablets to maintain normal values. She took only low-dose hydralazine to maintain normal blood pressure. Further investigations revealed PA with a left adrenal tumor. After left adrenalectomy, she remained in a normotensive, normokalemic and normomagnesemic state without any medical supplements. Thus, PA should be considered in patients with severe hypomagnesemia without moderate to severe hypertension. |
| first_indexed | 2024-12-18T00:01:41Z |
| format | Article |
| id | doaj.art-26e08d258f734b1486cba622d0d212f8 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-12-18T00:01:41Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-26e08d258f734b1486cba622d0d212f82022-12-21T21:27:55ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492019-01-0141186286510.1080/0886022X.2019.16624391662439Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimicPhatharaporn Kiatpanabhikul0Wasakorn Bunyayothin1Charoenkrung Pracharak HospitalCharoenkrung Pracharak HospitalPrimary hyperaldosteronism (PA) usually presents with moderate to severe hypertension with or without hypokalemia in adults. However, PA is not commonly associated with severe hypomagnesemia. By contrast, Gitelman syndrome usually presents with clinical manifestations of hypokalemia and hypocalcemia due to hypomagnesemia. Here, we present the case of a 44-year-old woman who first presented with peripheral paresthesia. Her laboratory tests revealed severe hypokalemia, metabolic alkalosis, severe hypomagnesemia, hypocalcemia and secondary hyperparathyroidism. The patient took high dose KCL tablets and Mg tablets to maintain normal values. She took only low-dose hydralazine to maintain normal blood pressure. Further investigations revealed PA with a left adrenal tumor. After left adrenalectomy, she remained in a normotensive, normokalemic and normomagnesemic state without any medical supplements. Thus, PA should be considered in patients with severe hypomagnesemia without moderate to severe hypertension.http://dx.doi.org/10.1080/0886022X.2019.1662439hypomagnesemiaprimary hyperaldosteronismgitelman syndromehypokalemiahypertension |
| spellingShingle | Phatharaporn Kiatpanabhikul Wasakorn Bunyayothin Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic Renal Failure hypomagnesemia primary hyperaldosteronism gitelman syndrome hypokalemia hypertension |
| title | Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic |
| title_full | Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic |
| title_fullStr | Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic |
| title_full_unstemmed | Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic |
| title_short | Uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia: a Gitelman syndrome mimic |
| title_sort | uncommon presentation of primary hyperaldosteronism with severe hypomagnesemia a gitelman syndrome mimic |
| topic | hypomagnesemia primary hyperaldosteronism gitelman syndrome hypokalemia hypertension |
| url | http://dx.doi.org/10.1080/0886022X.2019.1662439 |
| work_keys_str_mv | AT phatharapornkiatpanabhikul uncommonpresentationofprimaryhyperaldosteronismwithseverehypomagnesemiaagitelmansyndromemimic AT wasakornbunyayothin uncommonpresentationofprimaryhyperaldosteronismwithseverehypomagnesemiaagitelmansyndromemimic |