18 August 2018

Published by Oxford University Press on behalf of the Association of Physicians

QJM: An International Journal of Medicine, 2017, 175–177

 doi: 10.1093/qjmed/hcw224 

Case Report

Authors: T.H. Toh, C.V. Tong and H.C. Chong


Department of Internal Medicine, Malacca General Hospital, Malacca, Malaysia Address correspondence to T.H. Toh, Department of Internal Medicine, Malacca General Hospital, Malacca, Malaysia. email: yuy-987@hotmail.com 

Learning point for clinicians

Primary aldosteronism is one of the few potentially curable causes of hypertension and it requires a high index of suspicion in making an accurate diagnosis. This case illustrates the importance of looking at electrolytes other than just the potassium in a patient with severe primary aldosteronism. 


Primary aldosteronism is a well established cause of secondary hypertension, typically manifesting with hypertension, hypokalemia and metabolic alkalosis. On the other hand, its effects on calcium, magnesium and phosphate metabolism are less well reported. In this report, we present a case of severe primary aldosteronism due to adrenal adenoma who presented with a prolonged period of hypocalcemia, hypomagnesemia and hypophosphatemia along with uncontrolled hypertension and hypokalemia. 

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