A case of primary aldosteronism with rhabdomyolysis in which the first symptoms were thyrotoxicosis and peripheral paralysis and literature review.

ABSTRACT

Background: Primary aldosteronism (PA) is one of the main causes of secondary endocrine hypertension, especially refractory hypertension. Increased autonomous secretion leads to increased blood pressure and proinflammatory effects on different organ systems, including the cardiovascular system. However, because of its diverse clinical manifestations or the combination of other conditions, it sometimes causes problems for correct diagnosis. Therefore, we report and review the characteristics of some atypical and uncommon special case cases related to proaldosterone to provide clinical ideas for correct diagnosis and decision-making of proaldosterone. Case Description A 38-year-old male patient with fatigue and bilateral lower extremity pain came to the clinic and was found to have abnormal thyroid function, low blood potassium, elevated blood pressure, and also combined with rhabdomyolysis (RM) after further improvement of functional tests and imaging tests was diagnosed with an adrenal cortical adenoma (aldosteronism), hypertension secondary to PA, hypokalemia secondary to PA, RM, and subacute thyroiditis. After laparoscopic resection of a unilateral adrenal adenoma, the patient's blood pressure and blood potassium gradually returned to normal, and thyroid function returned to normal without additional intervention. Conclusions: Early screening should be performed for the high-risk population of PA to prevent the occurrence of RM and other serious complications caused by the progression of the disease. For patients with RM, the primary disease should be approached radically and should be based on symptomatic treatment. For RM syndrome associated with thyroid dysfunction, the etiology of the thyroid dysfunction should be actively identified to guide appropriate clinical management.