Aldosterone-producing
adenoma, which is characterized by
hypertension,
hypokalemia, and elevated
aldosterone levels with suppressed plasma
renin activity, is a rare condition during childhood and is also potentially curable. To the best of our knowledge, nearly 25 cases of childhood
aldosterone-secreting
adenoma have been reported in the literature to date. Here we describe a 13-yr-old girl with
primary hyperaldosteronism secondary to
aldosterone-secreting
adenoma. The patient was admitted to our hospital with the neuromuscular complaints of
muscle weakness and inability to walk due to
hypokalemia. She had been misdiagnosed as having
hypokalemic periodic paralysis 2 months before admission and her symptoms had radically improved with
potassium supplementation. However, her blood pressure levels had increased and her symptoms reappeared 2 days prior to being observed during hospitalization in our institution. Laboratory examinations revealed
hypokalemia (2.1 mEq/l), and increased serum
aldosterone levels with suppressed plasma
renin activity. Abdominal ultrasonography and abdominal magnetic resonance imaging revealed left adrenal mass. Laparoscopic
adrenalectomy was performed and histopathological examinations showed benign adrenal
adenoma. Serum
aldosterone levels and blood pressure levels returned to normal after surgical intervention. This case demonstrates the importance of a systemic evaluation including blood pressure monitorization of children with
hypokalemia as intermittent
hypertension episodes may be seen; cases without
hypertension may be misdiagnosed as rheumatological or
neurological disorders such as
hypokalemic periodic paralysis, as in our case.