Luljeta Çakërri¹, Elira Myrtaj², Florian Toti², Gentian Vyshka^1,

The case of an Albanian patient is reported, with bilateral adrenal hyperplasia diagnosed after a condition of persistent hypokalemia, in spite of continuous and adequate potassium administration. The patient, a Caucasian male of middle age, was suffering from diabetes, hypertension and angina pectoris, and admitted in a University Hospital Facility due to an unexplained confusional state. U waves were registered in the electrocardiography, and abdominal imaging was suggestive of adrenal hyperplasia. His plasmatic levels of potassium started to improve and became normal only after a therapy with potassium sparing diuretic, in our case with spironolactone. The administration of this type of drug has been widely advocated even for diagnostic purposes, when an unexplained condition of hypokalemia persists. Our case suggests that in lack of obvious causes of hypokalemia, suspicions on the existence of a primary hyperaldosteronism should be formulated, and investigations or therapeutic interventions have to be purposefully shaped.

primary hyperaldosteronism, hypokalemia, spironolactone, adrenal gland hyperplasia