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April 1965

Hyperkalemic Paralysis Due to Adrenal Insufficiency

Author Affiliations


From the Department of Medicine, University of Kansas Medical Center and Kansas City Veterans Administration Hospital. Resident in Medicine (Dr. Bell); Assistant Professor of Medicine (Dr. Hayes); Intern (Dr. Vosburgh).

Arch Intern Med. 1965;115(4):418-420. doi:10.1001/archinte.1965.03860160044007

FLACCID muscle paralysis due to electrolyte imbalance is seen in a number of clinical entities. Hypokalemic periodic paralysis 1 and the paralysis of primary aldosteronism2 are due primarily to a low serum potassium. Hyperkalemia due to renal failure 3 or hyperkalemic periodic paralysis 4 can cause a similar clinical picture. Since some degree of hyperkalemia is usually seen with adrenal insufficiency, it is surprising that flaccid muscle paralysis has not been more frequently observed in association with Addison's disease. To date there have been only six cases reported.5-10 The following patient, who had had a bilateral adrenalectomy eight months previously for control of malignant hypertension, is the seventh.

Report of Case 

History.  —A 41-year-old carpenter was first admitted to Kansas City Veterans Hospital in 1961 for severe hypertension. On his initial admission he had a blood pressure of 280/160 and papilledema with retinal hemorrhages. His blood pressure could