A Rare Case of Primary Hyperaldosteronism Resulting in Severe Hypokalemia

Hyperaldosteronism often clinically manifests as hypertension with mild to moderate hypokalemia. However, in rare cases, it can also present primarily with severe hypokalemia. In this case report, we will be discussing our patient, a 43-year-old woman who presented with abdominal cramps and vomiting, along with severe muscle cramps resulting in an inability to walk. She was found to have an undetectable level of serum potassium and prolonged QT interval on her ECG. After aggressive electrolyte correction and further imaging and endocrinology studies, she was diagnosed to have primary hyperaldosteronism. She was appropriately referred for urgent outpatient adrenalectomy, which turned out to be curative. Our case highlights the importance of timely diagnosis, interventions, and multidisciplinary care for patients with primary hyperaldosteronism.