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Nearly fatal hypokalaemia due to non-hypertensive primary hyperaldosteronism in the post partum
  1. Juliana Marques-Sá,
  2. Mariana Barbosa,
  3. Vera Fernandes and
  4. Maria Joana Santos
  1. Endocrinology Department, Braga Hospital, Braga, Portugal
  1. Correspondence to Dr Mariana Barbosa; marianamb013{at}


A previously healthy postpartum 33-year-old woman was admitted at the emergency department after two episodes of syncope. In the waiting room, she collapsed, ventricular fibrillation was detected, and she was reanimated by electric cardioversion. At admission, she was conscient, with blood pressure of 102/74 mm Hg and heart rate of 78 bpm. In the laboratory workup, severe hypokalaemia was found (K+ 1.77 mEq/L). Abdominopelvic CT revealed a 27 mm nodule in the right adrenal gland. High aldosterone and low plasma renin levels were detected, and the diagnosis of primary hyperaldosteronism was made, although she never had hypertension. Posteriorly, a cosecretion of aldosterone and cortisol was found. Two months after admission, the patient remained stable with normal K+ levels under spironolactone and a right adrenalectomy was performed. The cure of primary hyperaldosteronism and a partial adrenal insufficiency were confirmed. K+ levels and blood pressure remained normal without treatment and 10 months after surgery hydrocortisone was suspended.

  • endocrine system
  • resuscitation
  • adrenal disorders
  • fluid electrolyte and acid-base disturbances

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  • JM-S and MB contributed equally.

  • Contributors JM-S and MB contributed equally to the present work, being cofirst authors. JM-S and MB contributed to patient information collection and literature review. All authors assisted the patient when she was at the hospital and participated in clinical follow-up. All authors contributed to writing and revising the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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